Wednesday 16 November 2011

Emedinews:Insights on Medicolegal issues:Alcohol and Isopropanol poisoning

• The effect of ethanol depends on how much alcohol a person regularly drinks. Someone who does not usually drink much alcohol may be badly affected by an amount that would have very little effect on a person who regularly drinks large amounts.
• Children may get severe poisoning after drinking just a mouthful of aftershave, mouthwash or perfume. Isopropanol is more poisonous than ethanol. Serious poisoning can be caused by using isopropanol as rubbing alcohol, if large amounts are rubbed on the skin and absorbed into the body.
• Both ethanol and isopropanol slow down the brain, causing unconsciousness and shallow breathing. Isopropanol vapor is irritant to eyes, nose and throat and poisonous if breathed in. Isopropanol can cause poisoning if absorbed through the skin.
• Slurred speech, difficulty in performing simple tasks, staggering walk, nausea, vomiting, and abdominal pain with blurred or double vision, unconsciousness, fits are more severe after isopropanol intoxication.
• If breathing stops, open the airway and give mouth-to-mouth respiration. If the patient is unconscious or drowsy, lay him or her on one side in the recovery position. Check breathing every 10 minutes and keep the patient warm. Take the patient to hospital as soon as possible if the patient is a child, the patient has severe poisoning, the patient has swallowed isopropanol.
• Doctor must check for blood glucose which may be low and there may be metabolic acidosis and electrolyte imbalance. Do a full medical examination to exclude other causes of the patient's condition, such as head injury. Ensure the airway is clear and the patient remains in the recovery position. Monitor breathing, blood pressure, pulse, and blood glucose. Supportive care, including oxygen and ventilation, should be given as needed:
• Fluid and electrolyte balance should be corrected and hypoglycemia should be treated with oral or intravenous glucose.

(Contributed by Dr Sudhir Gupta)

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