【Health Science】A warm reminder from Dr. Sun from the Emergency Department of Nanyang Medical College Second Affiliated Hospital
Hello everyone, I am Dr. Sun of the Emergency Department of nanyang medical college second affiliated hospital, it is the Spring Festival, as the saying goes, every festive season is more than thinking of relatives, it is indispensable to drink two pounds of liquor, here I want to remind everyone: "Drink less and be happy, drink big and hurt the body."
At about 16:00 on February 4, "Doctor ... Doctor...", suddenly an urgent voice came through the door of the emergency hall, I and Dr. Ban Huang jumped up from the chair, rushed to the door, saw a car rear seat was supported by the family to sit a man in his 50s, has been called out, immediately pushed the patient to the rescue room, assess the carotid artery pulse disappearance, mydriasis, immediate chest compressions, monitoring, defibrillation, balloon assisted breathing, establish venous access, adrenaline and other rescue drug applications, emergency tracheal intubation, ask for medical history, For the emergency department daily, everyone's cooperation tacit understanding, do the clouds and flow. After inquiring about the medical history in detail, I learned that the patient has long been addicted to alcohol, this is a festival, at noon with relatives and friends, the mood is high, excessive drinking, just ten minutes ago, on the way home, suddenly called out, the family rushed to our hospital, there was a tense scene at the beginning.
During the New Year's Festival, the hospital often accepts patients with acute alcoholism, and in severe cases, they are even "drunk and unconscious". This is not, the New Year festival, today for everyone to summarize the treatment of acute alcoholism to deal with the main points, article just need, quickly take the small book to remember!
1. Prevent aspiration
Aspiration is the leading cause of death in patients with acute alcoholism, so it is necessary to tilt the patient's head to one side, must not lie on their backs, prevent vomit from being sucked into the trachea, induce aspiration pneumonia or even lead to asphyxia, or vomit stimulates the trachea, causing reflex cardiac arrest through vagus nerve reflexes. Depending on the situation, gastric lavage is carried out with an intubation tube and gastric emptying measures are carried out. At the same time, complications such as aspiration pneumonia are treated accordingly.
2. Pay attention to keep warm
Patients with acute alcoholism have poor perception of external temperature and slow response, and after drinking alcohol, the blood vessels of the whole body are dilated and a large amount of heat is emitted, especially in a cold environment, which is easy to cause hypothermia, which induces hypercoagulable blood, hyperglycemia and arrhythmia, resulting in accidental death. Therefore, when receiving patients with acute alcoholism, the room temperature should be appropriately increased, covered with a quilt, warm measures should be taken, and energy should be replenished, and bed sheets and clothes should be changed in time to avoid colds. If the patient develops hypothermia, the temperature should be raised slowly to normal levels (≤ 0.6°C per hour) to avoid rapid rewarming causing irreversible hypotension.
3. Monitor blood glucose
Hypoglycemia occurs often 6 to 24 hours after moderate or heavy alcohol consumption, but can also occur soon after alcohol consumption. Patients often present with coma, stiffness, pulse rate, hyperhidrosis, low body temperature, and an alcohol-based odor on exhalation.
4. Be wary of acute pancreatitis
After acute alcoholism, pay attention to the symptoms of false abdominal pain. At present, acute alcoholic pancreatitis is rare in China, which may be related to the small amount of alcohol consumption, the habit of slow drinking and meat dishes.
5. Identify disulfiram-like reactions
Cephalosporin is wine, and when it is said, it is gone. Not scary, vigilant for disulfiram-like reactions, this reaction mostly occurs within 0.5 hours after drinking alcohol, mainly manifested as facial flushing, blurred vision, headache, shortness of breath, chest tightness, nausea, vomiting, increased heart rate, limb weakness, hyperhidrosis, insomnia, severe blood pressure drop, dyspnea, and even loss of consciousness, convulsions and death, generally lasting 2 to 6 hours.
6. Can induce acute myocardial infarction
Especially the elderly and patients with underlying medical conditions such as diabetes. Alcohol consumption can induce acute myocardial infarction, especially in drowsy drinkers who are more insidious or even have no symptoms, at which time an electrocardiogram is crucial.
7. Use sedatives with caution
People with acute alcoholism should use caution when using sedatives. For patients with restlessness or hyperexcitability, especially in patients with aggressive behavior, diazepam, intramuscular injection is safer than intravenous injection, with care to monitor breathing and blood pressure. Avoid chlorpromazine, morphine, phenobarbital sedatives.
8. Strictly grasp the indications for gastric lavage
Alcohol is absorbed quickly and there is an increased risk of aspiration and damage to the gastric mucosa. Therefore, attention should be paid to assessing the patient's condition, weighing the pros and cons, and strictly grasping the indications for gastric lavage in patients with acute alcoholism.
Dr. Sun once again reminded the general public that if a drunken person is already unconscious, tilt his head to one side and lie on his side to avoid lying flat and causing vomit to inhale and suffocate. If the patient is still unconscious, the call does not respond, the breathing rate is not correct, the face is blue, the lips are purple, and the limbs are cold, serious complications may occur. If there is aspiration, the original patients with high blood pressure and heart disease have cerebral hemorrhage, heart disease recurrence, etc., and need to be sent to the hospital for emergency treatment.
The opening patient has been rescued by emergency department and has turned the crisis into safety, so don't read it. Health is the stake, life is at stake! Your health my pursuit, your satisfaction my goal!
Source: Nanyang Medical College No. 2 Affiliated Hospital
