As one of the most frequent substances of abuse, particularly in the Western world [1], alcohol (in the form of ethanol) exerts numerous harmful effects on the human body if present in high concentrations. Acute alcohol intoxication (or "binge drinking" which is defined as the consumption of more than four alcoholic beverages for women and more than five for men in a short period of time, is described as the main culprit) is responsible for a significant amount of accidents and emergency visits [1] [2] [3] [4]. Although alcohol intoxication is predominantly diagnosed in males, it is well-known that females require less amounts of alcohol in order to attain toxic concentrations [5]. The spectrum of signs and symptoms is diverse [1] [2] [3] [4]. Behavioral changes such as euphoria and aggressiveness, as well as slurred speech, are seen in milder intoxications [1] [6], which are estimated to occur at blood ethanol concentrations of 150-250 mg/ml [2]. Gait disturbance, cognitive dysfunction (memory impairment) nausea, vomiting, visual deficits (diplopia, mydriasis), and hypothermia are symptoms encountered in more pronounced intoxication, whereas altered consciousness, stupor, coma, and even death due to respiratory insufficiency are indicators of severe intoxication [1] [2] [6] [7] [8]. The life-threatening nature of acute alcohol intoxication stems from many complications that arise in the presence of large quantities of ethanol in the circulation (> 350mg/100ml) [2], including lactic acidosis, hypokalemia, hypoglycemia, thromboembolic events, and cardiac arrhythmias [1] [2].

• Falling

  These factors probably contribute to the increased risk of falling when intoxicated with alcohol. KEYWORDS: Ethanol; adaptation; balance; postural control; vision [ncbi.nlm.nih.gov]

  Do not leave an intoxicated person alone, as he or she is at risk of getting injured from falling or choking. Keep the person on the ground in a sitting or partially upright position rather than in a chair. Help a person who is vomiting. [niaaa.nih.gov]

  Make sure the person will not fall or get hurt. Place the person on their side in case they throw up (vomit). DO NOT make the person throw up unless told to do so by a health care professional or Poison Control. [nlm.nih.gov]

• Hypothermia

  Symptoms range from changes in behavior to severe hypothermia, vomiting, altered consciousness, coma, and respiratory insufficiency that may be fatal. [symptoma.com]

  Coma, vomiting and hypothermia are the commonest symptoms in young teenagers intoxicated by alcohol. The biochemical disturbances in children 11-16 years of age with alcohol intoxication resemble those of adults. [ncbi.nlm.nih.gov]

  February 27, 2014 at 3:41 pm Jake Anderson (credit: CBS) MINNEAPOLIS (WCCO) – The 19-year-old University of Minnesota student found dead near the Stone Arch Bridge in December died of hypothermia with acute alcohol intoxication contributing, officials [minnesota.cbslocal.com]

  Signs and symptoms of alcohol poisoning The signs and symptoms of alcohol poisoning include: confusion severely slurred speech loss of co-ordination vomiting irregular or slow breathing pale or blue-tinged skin caused by low body temperature (hypothermia [nhs.uk]

• Impaired Balance

  As intoxication becomes more severe, patients will exhibit an unsteady gait and impaired balance. [emsworld.com]

• Vomiting

  Symptoms range from changes in behavior to severe hypothermia, vomiting, altered consciousness, coma, and respiratory insufficiency that may be fatal. [symptoma.com]

  Unconscious or semi-conscious Slowed or irregular breathing (eight or less breaths per minute) or lapses in breathing of more than 10 seconds Cold, clammy or pale/bluish skin Vomiting while “sleeping” or passed out, and not waking up after vomiting Appropriate [ramapo.edu]

  […] become severely dehydrated, which can cause permanent brain damage in extreme cases develop more severe hypothermia have fits (seizures) as a result of lowered blood sugar levels Repeated vomiting and retching can lead to vomiting blood, caused by a [nhs.uk]

• Nausea

  Gait disturbance, cognitive dysfunction (memory impairment) nausea, vomiting, visual deficits (diplopia, mydriasis), and hypothermia are symptoms encountered in more pronounced intoxication, whereas altered consciousness, stupor, coma, and even death [symptoma.com]

  […] of present illness: A 46-year-old female with a history of an aortic arch repair secondary to invasive aspergillosis in addition to a known history of gallstones presented to the emergency department with two days of right upper quadrant pain, fever, nausea [jetem.org]

  Table 7: Clinical Institute Withdrawal Assessment Scale Criteria Rating Nauseau and vomiting 0 = No nausea or vomiting 1 = Mild nausea with no vomiting 7= Constant nausea and frequent vomiting Tremors 0 = No tremor 1 = Tremors not visible but can be felt [emsreference.com]

  Symptoms include nausea, vomiting, and abdominal pain. [medicalnewstoday.com]

  In some cases, medication is used to relieve nausea or vomiting. [theravive.com]

• Tachycardia

  Take the patient’s blood pressure to ascertain if there are any orthostatic changes, hypotension, or tachycardia. [medical-dictionary.thefreedictionary.com]

  Significant findings: The patient’s vital signs were significant for tachycardia. Physical exam was notable for a positive Murphy’s sign. Initial labs were significant for leukocytosis with an elevated alkaline phosphatase. [jetem.org]

  The tachycardia was attributed to dehydration from vomiting by the treating clinician. The patient's tachycardia settled down after the 20 mL/kg i.v. saline infusion. [ncbi.nlm.nih.gov]

  Vital signs include a normal to elevated blood pressure, tachycardia, and normal to fast respiratory rate. [emsreference.com]

  The physical examination may reveal fever, tachycardia, and tenderness in the RUQ or epigastric region, often with guarding or rebound. However, the absence of physical findings does not rule out the diagnosis of cholecystitis. (See Presentation.) [emedicine.medscape.com]

• Hypotension

  Intoxicated patients were more likely to be hypotensive on admission (p = 0.01) despite a lower liver injury grade and no significant difference in ISS. [ncbi.nlm.nih.gov]

  Take the patient’s blood pressure to ascertain if there are any orthostatic changes, hypotension, or tachycardia. [medical-dictionary.thefreedictionary.com]

  Patient evolved in the post-anesthetic care unit with hypotension, hypoxemia and mental confusion, which were reverted with intravenous hydration and elevation of lower limbs. [scielo.br]

  Immediate correction of clinical volume depletion and hypotension with isotonic crystalloid infusion (saline). [clinicaladvisor.com]

• Flushing

  Alcohol intoxication is manifested by such signs as facial flushing, slurred speech, unsteady gait, euphoria, increased activity, volubility, disorderly conduct, slowed reactions, impaired judgement and motor incoordination, insensibility, or stupefaction [who.int]

  Without this enzyme, ingestion of ethanol results in facial flushing, occasionally with nausea and tachycardia, in a syndrome colloquially known as the "Asian flush.” Nystagmus. Miosis. [clinicaladvisor.com]

  A ► Alcohol flush reaction ‎ (1 C, 12 F) ► Drunken people in art ‎ (22 C, 152 F) D ► Drunk driving ‎ (5 C, 61 F) F ► Drunken females ‎ (6 F) H ► Hangover ‎ (2 C, 19 F) M ► Drunken males ‎ (36 F) File nella categoria "Drunken people" Questa categoria contiene [commons.wikimedia.org]

  To gauge another person’s level of intoxication, try looking for the following signs: a loss of coordination, such as stumbling or swaying flushing of the face bloodshot eyes louder speech than usual slurred speech damp or clammy skin mood swings or personality [medicalnewstoday.com]

• Diplopia

  The second patient (male, 62 years old) developed diplopia, dysarthria and trunk ataxia after consuming 4-units of alcohol, and his symptoms were attributed to alcohol intoxication. [ncbi.nlm.nih.gov]

  Gait disturbance, cognitive dysfunction (memory impairment) nausea, vomiting, visual deficits (diplopia, mydriasis), and hypothermia are symptoms encountered in more pronounced intoxication, whereas altered consciousness, stupor, coma, and even death [symptoma.com]

  Wernicke's syndrome occurs acutely and patients present with confusion, visual impairment (diplopia) and ataxia. Korsakoff's syndrome occurs more chronically and is characterised by memory deficits and confabulation. [patient.info]

• Blurred Vision

  vision Slurred speech Pain is dulled Stupor Cannot stand or walk Vomiting Unconsciousness is possible Decreased response to stimuli Apathetic Coma Unconscious Low body temperature Possible death Shallow breathing Slow pulse Death Death as a result of [casapalmera.com]

  Acute visual changes such as photophobia or blurred vision may suggest methanol toxicity. Acute kidney injury, symptomatic hypocalcemia may suggest ethylene glycol toxicity. [clinicaladvisor.com]

  Visual disturbances, including decreased visual acuity, photophobia, and blurred vision, and abdominal pain are the most common symptoms of methanol intoxication ( 7, 64 ), one or both being found in 37 to 72% of patients ( 7, 64 ). [cjasn.asnjournals.org]

• Conjunctival Injection

  The International Classification of Diseases-10 Y91 codes 11 were used to define the 10 signs of alcohol intoxication: smell of alcohol, conjunctival injection, impairments in speech, motor coordination, judgment, mood, behaviour, emotion, cooperation [ncbi.nlm.nih.gov]

  Findings on physical examination include: Head, Eyes, Ears, Nose, Throat: Facial flushing and conjunctival injection. [clinicaladvisor.com]

• Euphoria

  Behavioral changes such as euphoria and aggressiveness, as well as slurred speech, are seen in milder intoxications, which are estimated to occur at blood ethanol concentrations of 150-250 mg/ml. [symptoma.com]

  Alcohol intoxication is manifested by such signs as facial flushing, slurred speech, unsteady gait, euphoria, increased activity, volubility, disorderly conduct, slowed reactions, impaired judgement and motor incoordination, insensibility, or stupefaction [who.int]

  We see these varying degrees of intoxication below: Euphoria Difficulty concentrating Talkative Lowered inhibitions Brighter color in the face Fine motor skills are lacking Excitement Senses are dulled Poor coordination Drowsy Beginnings of erratic behavior [casapalmera.com]

  Euphoria If a person has generally consumed two to three drinks as a man or one to two drinks as a woman in an hour, they’ll enter the euphoric stage of intoxication. [healthline.com]

• Aggressive Behavior

  Abstract This study investigated the relationships between provocation, acute alcohol intoxication, impaired frontal-lobe function, and aggressive behavior. [ncbi.nlm.nih.gov]

  Aggressive behavior was operationalized as the shock intensities administered to the fictitious opponent under conditions of low and high provocation. Of all the variables, provocation was the strongest elicitor of aggression. [history.as.uky.edu]

  Clinically significant maladaptive behavioral or psychological changes (e.g., inappropriate sexual or aggressive behavior, mood lability, impaired judgment, impaired social or occupational functioning) that developed during, or shortly after, alcohol [hams.cc]

• Visual Hallucination

  Patients experience hallucinations, anxiety and a coarse peripheral tremor. On examination, patients may be pyrexial, tachycardic and hypertensive. They may also develop seizures and auditory and visual hallucinations. [patient.info]

  The episode may escalate to include fleeting hallucinations, illusions that arouse fear and restlessness, and disorientation with visual hallucinations that may be terrifying. [msdmanuals.com]

• Mood Swings

  To gauge another person’s level of intoxication, try looking for the following signs: a loss of coordination, such as stumbling or swaying flushing of the face bloodshot eyes louder speech than usual slurred speech damp or clammy skin mood swings or personality [medicalnewstoday.com]

  swings Nausea Partial loss of understanding Possibility of stupor Vomiting Amnesia (memory blackout) Unconsciousness Severe physical disability 0.300–0.399 65.1-86.6 Central nervous system depression Lapses in and out of consciousness Loss of understanding [en.wikipedia.org]

• Confusion

  Alcohol, Vitamin B1 – Thiamine Deficiency and Brain Damage Acute alcohol intoxication will typically produce unsteadiness, slurring of speech and mild confusion. [stewartnutrition.co.uk]

  Confusion If a man consumes more than five drinks or a woman more than 4 drinks in an hour, they’ll enter the next stage of intoxication: confusion. This stage of intoxication is marked by emotional outbursts and a major loss of coordination. [healthline.com]

  Call 911 if the person has these symptoms of alcohol poisoning: Mental confusion or unconsciousness Repeated vomiting Seizures Slow or irregular breathing Low body temperature Pale, clammy, or bluish skin 1. [webmd.com]

• Slurred Speech

  Behavioral changes such as euphoria and aggressiveness, as well as slurred speech, are seen in milder intoxications, which are estimated to occur at blood ethanol concentrations of 150-250 mg/ml. [symptoma.com]

  One (or more) of the following signs, developing during, or shortly after, alcohol use: (1) slurred speech (2) incoordination (3) unsteady gait (4) nystagmus (5) impairment in attention or memory (6) stupor or coma D. [hams.cc]

  Introduction One of the most commonly abused substances Particularly dangerous when combined with stimulants (caffeine, cocaine) Presentation Symptoms (in order of increasing EtOH plasma level) disinhibition emotional lability slurred speech gait disturbances [step2.medbullets.com]

  The patient with acute ethanol poisoning may present with symptoms ranging from slurred speech, ataxia and incoordination to coma, potentially resulting in respiratory depression and death. [ncbi.nlm.nih.gov]

• Stupor

  Gait disturbance, cognitive dysfunction (memory impairment) nausea, vomiting, visual deficits (diplopia, mydriasis), and hypothermia are symptoms encountered in more pronounced intoxication, whereas altered consciousness, stupor, coma, and even death [symptoma.com]

  Symptoms of alcohol poisoning: Unable to stand or walk, or can only do so with difficulty Only vaguely aware of their surroundings Difficulty breathing Passed out or in a stupor Feverish or chilled Difficulty speaking or identifying oneself to others; [mcwell.nd.edu]

  Symptoms of alcohol poisoning: Unable to stand or walk, or can only do so with difficult Only vaguely aware of his surroundings Difficulty breathing Passed out or in a stupor Feverish or chilled Difficulty speaking or identifying oneself to others; obnoxious [ramapo.edu]

  MSG © biblegateway Pro 23:21 Drunks and gluttons will end up on skid row, in a stupor and dressed in rags. [web.archive.org]

• Ataxia

  The first patient (female, 50 years old) had dysarthria, nystagmus and trunk ataxia on admission. Her blood alcohol level was 2.3‰. [ncbi.nlm.nih.gov]

  In mild to moderate intoxication, mild incoordination, euphoria, ataxia, nystagmus, disinhibition and impaired judgment may result. [clinicaladvisor.com]

  Disinhibition of normal social functioning Euphoria (excessive talking, showing off) Ataxia (uncoordinated gait-walking) Poor judgment Loss of memory Slurred speech Worsening ataxia Vomiting Confusion and disorientation Progressive lethargy and coma Ultimately [emedicinehealth.com]

• Altered Mental Status

  Serum ethanol levels may be ordered in suspected alcohol ingestion as well altered mental status of unknown etiology, coma, psychiatric emergencies, traumatic emergencies, and history of other ingestions (eg, toxic alcohol, salicylates). [emedicine.medscape.com]

  Debra Posted Tue 28th of October, 2014 16:35:08 PM When patient's present to the Emergency Room intoxicated with altered mental status or ALOC, they may receive services to rule out other possible conditions, e.g. [supercoder.com]

  All patients with altered mental status should have a blood glucose determined and dextrose administered if they are found to be hypoglycemic. [emsworld.com]

  Hypoglycemia is common in ethanol intoxication/toxicity due to ethanol induced suppression of gluconeogenesis and marked hypoglycemia can be causative or contributive to an altered mental status. Temperature. [clinicaladvisor.com]

Because of the devastating role of alcohol in the overall mortality rates (1 in 10 deaths were attributed to alcohol abuse according to certain reports, with half of the cases being due to acute alcohol intoxication after binge drinking) [3] [4], the importance of recognizing signs and symptoms early on is pivotal for making an early diagnosis and initiating appropriate treatment. One of the first and most important steps in the workup is a thoroughly obtained patient history (which often includes a heterogeneous anamnesis from the patient's friends or family) that will identify excessive alcohol consumption (the amount of alcohol ingested, what kind of alcoholic beverages were consumed and the timeframe) and lead to a presumptive diagnosis. After a thorough physical examination and assessment of vital signs (blood pressure, temperature, heart rate, etc.), laboratory studies should be immediately employed, comprised of a complete blood count (CBC), serum electrolytes, glucose levels, arterial blood gas (ABG) analysis, and urinalysis (including urine output) [2]. Some studies have confirmed elevated liver transaminase levels (alanine and aspartate aminotransferase, or ALT And AST, respectively) and an abnormal ratio, thus their inclusion in the laboratory panel is recommended in the case of acute alcohol intoxication [5].

• Ketonuria

  Urinalysis and urine toxicology for the presence of opiates and cocaine metabolites, ketonuria or evidence of infection. [clinicaladvisor.com]

• Hypoglycemia

  Previous case reports suggest hypoglycemia and faster than normal rates of alcohol elimination found in children with acute alcohol intoxication compared with adults, but data are lacking. [ncbi.nlm.nih.gov]

  The life-threatening nature of acute alcohol intoxication stems from many complications that arise in the presence of large quantities of ethanol in the circulation (> 350mg/100ml), including lactic acidosis, hypokalemia, hypoglycemia, thromboembolic [symptoma.com]

  Williams HE (1984) Alcoholic hypoglycemia and ketoacidosis. Med Clin North Am 68: 33–38 Google Scholar 71. [link.springer.com]

  Because ethanol inhibits gluconeogenesis, hypoglycemia is common in patients on an ethanol infusion. [26] Hypoglycemia is particularly prevalent in pediatric patients on such drips. [emedicine.medscape.com]

• Hypophosphatemia

  To evaluate for evidence of acidosis, renal injury, hepatotoxicity, pancreatitis, coagulopathy, underlying chronic liver disease, electrolyte imbalances (e.g., hypomagnesemia, hypophosphatemia, hypocalcemia and hypokalemia) and malnutrition. [clinicaladvisor.com]

  Acute ethanol intoxication can lead to metabolic disturbances such as lactic acidosis, hypophosphatemia, hypokalemia and hypomagnesemia. [emsworld.com]

  Dehydration and electrolyte disturbances may develop during acute intoxication including hypokalemia, hypophosphatemia, hypocalcemia, and hyponatremia. 20 These abnormalities are largely due to nausea, vomiting, diarrhea, or increased urination that occurs [emsreference.com]

  Hyponatremia, hypokalemia and/or hyperkalemia, and hypophosphatemia are also commonly found ( 39, 112, 117 ). The serum osmolality is often normal, because AKA is often found after most of the ethanol has been metabolized ( 39, 112, 115 ). [cjasn.asnjournals.org]

• Hypophosphatemia

  To evaluate for evidence of acidosis, renal injury, hepatotoxicity, pancreatitis, coagulopathy, underlying chronic liver disease, electrolyte imbalances (e.g., hypomagnesemia, hypophosphatemia, hypocalcemia and hypokalemia) and malnutrition. [clinicaladvisor.com]

  Acute ethanol intoxication can lead to metabolic disturbances such as lactic acidosis, hypophosphatemia, hypokalemia and hypomagnesemia. [emsworld.com]

  Dehydration and electrolyte disturbances may develop during acute intoxication including hypokalemia, hypophosphatemia, hypocalcemia, and hyponatremia. 20 These abnormalities are largely due to nausea, vomiting, diarrhea, or increased urination that occurs [emsreference.com]

  Hyponatremia, hypokalemia and/or hyperkalemia, and hypophosphatemia are also commonly found ( 39, 112, 117 ). The serum osmolality is often normal, because AKA is often found after most of the ethanol has been metabolized ( 39, 112, 115 ). [cjasn.asnjournals.org]

• Calcium Decreased

  Serum parathyroid hormone levels exceeded base-line values during the last 4 hours of the 16-hour study period; this increase was accompanied by a decrease in the urinary excretion of calcium. [ncbi.nlm.nih.gov]

  In a manner consistent with the developing hypoparathyroidism, the serum levels of ionized and total calcium decreased and the urinary excretion of calcium increased. [nejm.org]

• Hypertriglyceridemia

  We can underline the gender, age, obesity, fast weight loss, alcohol use, diabetes, pregnancy, hypertriglyceridemia, and so on. The study of pathogenesis of gallstones can identify all etiological factors. [intechopen.com]

Abstract This randomized, open-label study evaluated the efficacy of 300 mg metadoxine (given intravenously) added to standard treatment compared with standard treatment alone in managing the physical and psychological signs of acute alcohol intoxication [ncbi.nlm.nih.gov]

Secondary outcomes were treatment time, breath alcohol levels, intoxication symptom score, level of intoxication and associated healthcare costs. [doi.org]

Because alcohol poisoning can be fatal, emergency treatment is urgently needed. [answers.yahoo.com]

Management Cholecystectomy Radical excision of bile duct with reconstruction Radical cholecystectomy Prognosis Good Medial survival 9 months 5 year survival <9% Investigation Investigation Check bloods which will show increase WCC. [armandoh.org]

Uncomplicated cholecystitis has an excellent prognosis; the development of complications such as perforation or gangrene renders the prognosis less favorable. [emedicine.medscape.com]

[…] is concern withdrawal long-acting benzodiazepines with taper addiction disulfiram inhibits acetaldehyde dehydrogenase → aversive conditioning naltrexone decreases desire to drink gabapentin topiramate also an anti-seizure and anti-migraine medication Prognosis [step2.medbullets.com]

[…] are well known. 1 There are a few case reports of alcohol-induced hypoglycemia in young children 2 and also case reports of withdrawal symptoms in infants of alcoholic mothers. 3 Yet there is very little in the literature on the course, treatment, and prognosis [pediatrics.aappublications.org]

In the first phase of the study, the patients have been divided by etiology of acute pancreatitis. The majority of cases (30 pts. 71%—Group A) shows biliary etiology, based on the detection with imaging study (US) of biliary lithiasis. [intechopen.com]

Answer: For first part you need to follow the ICD guideline of reporting etiology followed by symptom. Report first the alcohol poisoning or toxic effect of alcohol or alcohol abuse and then report AMS or ALOC. [supercoder.com]

Serum ethanol levels may be ordered in suspected alcohol ingestion as well altered mental status of unknown etiology, coma, psychiatric emergencies, traumatic emergencies, and history of other ingestions (eg, toxic alcohol, salicylates). [emedicine.medscape.com]

It is still important to consider alternative etiologies of metabolic acidosis such as lactic acidosis from profound volume depletion, sepsis, or bowel ischemia, and in diabetic patients, diabetic ketoacidosis (DKA). [clinicaladvisor.com]

The primary aims of this epidemiological study were to assess the prevalence and factors associated with acute alcohol intoxication among 57 813 suicide decedents in 16 states. [ncbi.nlm.nih.gov]

See: http://creativecommons.org/licenses/by-nc/4.0/ Statistics from Altmetric.com ACCIDENT & EMERGENCY MEDICINE EPIDEMIOLOGY Strengths and limitations of this study Data were collected by the treating clinician at the time of the admission decision thus [bmjopen.bmj.com]

He has since completed further training in emergency medicine, clinical toxicology, clinical epidemiology and health professional education. [lifeinthefastlane.com]

Grant BF, Goldstein RB, Saha T, et al : Epidemiology of DSM-5 alcohol use disorder results from the National Epidemiologic Survey on Alcohol and Related Conditions III. JAMA Psychiatry 72 (8):757–766, 2015. doi: 10.1001/jamapsychiatry.2015.0584. [merckmanuals.com]

The epidemiology of the epilepsies. Handbook of Clinical Neurology. 107. pp. 113–33. doi:10.1016/B978-0-444-52898-8.00006-9. ISBN 9780444528988. PMID 22938966.; Sander JW, Shorvon SD (1996). "Epidemiology of the epilepsies". [en.wikipedia.org]

Sleisenger and Fordtran's Gastrointestinal and Liver Disease: Pathophysiology/Diagnosis/Management. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 65. Updated by: Michael M. [medlineplus.gov]

The role of glutamatergic neurotransmission in the pathophysiology of alcoholism. Annu Rev Med. 1998 ;49: 173 - 184. Google Scholar | Crossref | Medline | ISI Alcohol Withdrawal Syndrome Guidelines. [doi.org]

One study found that consumption of spirits was more likely than wine or beer to cause acute pancreatitis. [ 4 ] The pathophysiology of alcohol-related pancreatitis is not clearly understood. [patient.info]

Pathophysiology Metabolic acidosis and visual problems, hallmarks of this disorder, are due to metabolites of methanol. [cjasn.asnjournals.org]

PMID 23398871. ^ "Aspiration Pneumonitis and Pneumonia: Overview of Aspiration Pneumonia, Predisposing Conditions for Aspiration Pneumonia, Pathophysiology of Aspiration Pneumonia". 3 February 2019. [en.wikipedia.org]

The study was part of a multicentre-funded injury prevention project based on the widely accepted Canadian Hospital Injury Reporting and Prevention Programme. [ncbi.nlm.nih.gov]

and Complications Complications ED Management Inpatient Management Chronic Management Prevent further ethanol intake Prevent individual from harming self or others Sedate patient if agitated or aggressive Order urine toxicity screen Stabilize vitals [step2.medbullets.com]

Have him or her lean forward to prevent choking. If a person is unconscious or lying down, roll him or her onto one side with an ear toward the ground to prevent choking. Stay alert to keep your friends and family safe. [niaaa.nih.gov]

1. Tõnisson M, Tillmann V, Kuudeberg A, Lepik D, Väli M. Acute alcohol intoxication characteristics in children. Alcohol and Alcoholism. 2013;48(4):390-395.
2. Morgan MY. Acute alcohol toxicity and withdrawal in the emergency room and medical admissions unit. Clin Med (Lond). 2015;15(5):486-489.
3. Kanny D, Brewer RD, Mesnick JB, Paulozzi LJ, Naimi TS, Lu H. Vital signs: alcohol poisoning deaths - United States, 2010-2012. MMWR Morb Mortal Wkly Rep. 2015;63(53):1238-1242.
4. Stahre M, Roeber J, Kanny D, Brewer RD, Zhang X. Contribution of excessive alcohol consumption to deaths and years of potential life lost in the United States. Prev Chronic Dis 2014;11:130293.
5. Binder C, Knibbe K, Kreissl A, et al. Does acute alcohol intoxication cause transaminase elevations in children and adolescents? Alcohol. 2016;51:57-62.
6. Bitunjac K, Saraga M. Alcohol Intoxication in Pediatric Age: Ten-year Retrospective Study. Croat Med J. 2009;50(2):151-156.
7. Lamminpää A. Alcohol intoxication in childhood and adolescence. Alcohol and Alcoholism. 1995 Jan;30(1):5-12.
8. National Institute of Alcohol Abuse and Alcoholism. Alcohol overdose: the dangers of drinking too much. Bethesda, MD: National Institute of Alcohol Abuse and Alcoholism; 2013.