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Case study of Alchohol poisoning in Kathmandu

The problem with country like Nepal is that people tend to drink alcohol a lot more than other nations be it local-made or imported due to lack of activities, employment etc. Lot of families and health of thousands have become ruined due to lack of awareness about the proper use of alcohol.

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Case study of Alchohol poisoning in Kathmandu

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  1. Case study on ETHANOL TOXICITY Prepared by Neeraj Ojha Yuvraj kalathoki

  2. INTRODUCTION Ethanol is a colourless, volatile liquid .It is miscible in water.Alcohol intoxication or alcohol poisoning is the negative behaviour and physical effects due the recent drinking of alcohol.At higher doses there may be slurred speech,trouble walking and vomiting.It is absorbed mainly through GIT by passive diffusion.It is a low molecular weight compound derived from the fermentation of sugars and cereals.

  3. ETHANOL METABOLISM PATHWAY

  4. ETHANOL TOXICITY

  5. CHRONIC ETHANOL TOXICITY

  6. CAUSES OF ALCOHOL INTOXICATION Alcohol intoxication occurs from drinking too much alcohol in a short period of time .Some people are more at risk of alcohol intoxication than others.Factors affecting your risk of alcohol intoxication include • Body type and body weight • Health status • Alcohol percentage in the drink

  7. contd.. • Rate and amount of alcohol consumption • Level of alcohol tolerance .

  8. EPIDEMIOLOGY Alcohol intoxication is commonin modern society,largely because of its widespread availability. Acute intoxication with any of the alcohols can result in respiratory depression,aspiration, hypotension and cardiovascular collapse. The onset of the later stages of toxic alcohol intoxication can also be delayed if ethanol is coingested.

  9. CLINICAL FEATURES/SYMPTOMS • Confusion • Vomiting • Seizures • Irregular breathing • Slow breathing • Tachycardia • Hypothermia • Blue tinged skin or pale skin

  10. ROUTES OF INGESTION • Oral ingestion • Inhalation • Intravenous ingestion.

  11. ACUTE AND CHRONIC ALCOHOL TOXICITY

  12. Chronic effects of alcohol on body • Liver cirrhosis • Physical mental and moral deterioration • Chronic gastroenteritis • Peripheral neuropathy • Impotence and sterility • Euphoria • Excitement

  13. TREATMENT AND MANAGEMENT Preliminary ABCD treatment is a must; For acute poisoning there are two types of treatment • First aid • Treatment in hospital • Treatment in hospital includes gastric lavage,artificial breathing,electrolytes,IV hypertonic glucose solution,Hemodialysis and peritoneal dialysis.

  14. Chronic alcohol poisoning treatment • Antabuse (DIsulfiram) OD dose of 0.5mg • Calcium carbimide (citrate salt ) OD dose of 50mg • Psychotherapy

  15. CASE STUDY A 20-year-old man was transferred to the hospital XYZ by ambulance because of a disturbance of consciousness and vomiting. He had started drinking 1 h before the Emergency Medical Service was notified of his altered consciousness. His serum ethanol concentration on arrival was 225 mg/dL, and the patient was admitted for treatment of intoxication.

  16. SUBJECTIVE DETAIL • Gender -male • Age -20 yrs old • Weight -65 kg

  17. OBJECTIVE DETAIL Arterial pH<7.3 (The normal range for pH is 7.35–7.45. As the pH decreases (< 7.35), it implies acidosis, while if the pH increases (> 7.45) it implies alkalosis) Serum bicarbonate<20mmol/L (Normal bicarbonate levels are: 23 to 30 mEq/L in adults) Osmolal gap>10mOsm/kg H20(A normal osmol gap is < 10 mOsm/kg)

  18. ASSESSMENT • So the patient was diagnosed of chronic alcohol poisoning.

  19. PLANNING • In cases of coma, endotracheal intubation would be needed, followed by artificial ventilation. • Generally, treatment is necessary, including avoidance of dehydration, hypothermia, hypotension, hypoglycemia, respiratory depression, metabolic acidosis, excitement, and anxiety

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