I need a new doctor (to get me drunk)

Miscellaneous and Personal Stuff I Must Share
21

[QUOTE=JayRx1981]
As for why it doesn’t kill the patient? The goal, as far as I can tell from some of my toxicology texts, is to hit a blood level which saturates the enzyme systems involved–which is well below the toxic blood levels needed for coma/death. They also treat the patient with vitamin replacements to replenish the cofactors alcohol uses up when its metabolized, as well as glucose to prevent the hypoglycemia that eventually leads to acidosis and the nasty complications of alcohol metabolism.
[/QUOTE]

thanks for the response. I guess the short version of it is that the level they keep (although it sounds like a lot) is still less than the frat boys pump into themselves. Medical drunkenness is more even than the spike of frat drinking, and never really reaches toxic levels. Right?

22

Yes,** Sapo**–that’s the idea.

Long, long ago, when I first started as an RN, we still had docs who would prescribe a shot of whiskey (or maybe it was vodka, my memory fails me) at a certain frequency–I think it was every 3 hours, maybe more often.

This was NOT for ETOH poisoning, but for the alcoholics who would be admitted for something else. It was to prevent DTs. I remember one 70+ year old man who was drunk when he lit his pile of leaves–and then stood in the pile. Burned his leg badly, but not extensively. He got the shot (or was it drams?) every 2-3 hours or so. It came from pharmacy in an official looking bottle (not fifths of liquor on the med cart) and was doled out in our clear plastic med cups (which make great shot glasses, BTW). It was not counted every shift like narcs were, but pharm did keep track of how much had been dispensed. Since it was in plastic bottle, the RN couldn’t say the bottle had broken etc. (not that she would have, anyway, but you never know).

This practice died very quickly when the 2-3 old time docs retired. Thank god for Librium and all it’s cousins.

23

My dad used to talk about back in the days of his residency.

Bums would find and drink antifreeze, then walk into the Emergency room and announce they had done it. They knew they would get some alcohol for free as a life saving measure. After a guy had done it two or three times they would just hand them a bottle of cheep vodka out the back door which the admin hid on the budget somewhere. It was cheeper then the medical grade stuff, and much safer for the bum since he didn’t drink antifreeze first.

That kind of stuff would never fly today.

24

[QUOTE=Sapo]
True, but this is what I was getting at. If (drinking) alcohol is poisonous at the levels one can achieve by drinking, how can 3 drinks an hour for 3 days not kill the patient? What else is at play here?
[/QUOTE]

Considering that they can monitor the blood alcohol level of the patient, and they are introducing the alcohol at a steady rate, they can keep him at a therapeutic level without getting to the point of risking death from it. My understanding is that they aim for a blood alcohol level around .15 - .2.

The biggest risk of alcohol poisoning is binge drinking, where someone drinks enough in quick succession that by the time they pass out from their blood alcohol level from the first 10 drinks, they have already consumed 5 more. The passing out should prevent us from continuing to poison ourselves.

25

Sorry I didn’t get back sooner. I think most of the questions have been answered.

ETOH is ethonol, which is alcohol made from food grains. Even though, we hear from the media about people who survive BAs above the “lethal limit,” That limit is dependent on several factors for each individual. One’s size is a big one.
STORY AHEAD
I once cared for a Somoan gentleman who was 6’7" and weighed more than 500 lbs. His BA was the highest ever seen in our hospital. He came in totally unresponsive. We spent the night trying to find next of kin for possible organ donation. (THAT unresponsive!) At 5 AM, I went into his room to take his vital signs. When I touched him, he opened his eyes, sat up pulled all his tubes and lines out and mumbled “I gotta get outa here, before the cops find me!” Then he left. I didn’t try to stop him.

Another factor is tolerance. Like many drugs, one’s body gradually builds a tolerance to ETOH. That’s why the media reports the occasional 120 pounder with a BA of 0.50, still walking around.

Sam I Am is correct. The amount of ETOH used in a drip is titrated to effect. The patient is kept “tipsy” but not unconscious. We do serial BA’s about once an hour, to be sure we aren’t over dosing.

Christopher, you’re correct Ethylene Glycol is the active ingredient in conventional anti-freeze. Propylene Glycol is used as a safer alternative.

ETOH is used for some herbicide poisonings as well. WARNING! ANOTHER STORY AHEAD
We had two farm workers admitted for herbicide poisoning. They were immediately put on ETOH drips and were soon very “happy.” Neither spoke a word of English, and since it was a weekend, we were having trouble finding a translator. I speak a little Spanish, but not enough to explain why we were making them drunk. They didn’t seem to mind, until we got more information from the field. It turned out the poison wasn’t an herbicide, but a pesticide, requiring completely different treatment. The new treatment included, among other things a strong laxative. So, we had two drunks with diarrhea.
I’m sure the poor guys thought american medicine was very strange.

They both did fine. the farmer was cited for using a potable water system to transport poisonous substances.

26

[QUOTE=picunurse]
Sorry I didn’t get back sooner. I think most of the questions have been answered.

ETOH is ethonol, which is alcohol made from food grains. Even though, we hear from the media about people who survive BAs above the “lethal limit,” That limit is dependent on several factors for each individual. One’s size is a big one.
STORY AHEAD
I once cared for a Somoan gentleman who was 6’7" and weighed more than 500 lbs. His BA was the highest ever seen in our hospital. He came in totally unresponsive. We spent the night trying to find next of kin for possible organ donation. (THAT unresponsive!) At 5 AM, I went into his room to take his vital signs. When I touched him, he opened his eyes, sat up pulled all his tubes and lines out and mumbled “I gotta get outa here, before the cops find me!” Then he left. I didn’t try to stop him.

Another factor is tolerance. Like many drugs, one’s body gradually builds a tolerance to ETOH. That’s why the media reports the occasional 120 pounder with a BA of 0.50, still walking around.

Sam I Am is correct. The amount of ETOH used in a drip is titrated to effect. The patient is kept “tipsy” but not unconscious. We do serial BA’s about once an hour, to be sure we aren’t over dosing.

Christopher, you’re correct Ethylene Glycol is the active ingredient in conventional anti-freeze. Propylene Glycol is used as a safer alternative.

ETOH is used for some herbicide poisonings as well. WARNING! ANOTHER STORY AHEAD
We had two farm workers admitted for herbicide poisoning. They were immediately put on ETOH drips and were soon very “happy.” Neither spoke a word of English, and since it was a weekend, we were having trouble finding a translator. I speak a little Spanish, but not enough to explain why we were making them drunk. They didn’t seem to mind, until we got more information from the field. It turned out the poison wasn’t an herbicide, but a pesticide, requiring completely different treatment. The new treatment included, among other things a strong laxative. So, we had two drunks with diarrhea.
I’m sure the poor guys thought american medicine was very strange.

They both did fine. the farmer was cited for using a potable water system to transport poisonous substances.
[/QUOTE]

One other use that has fallen out of favor (for obvious reasons) was slowing permature labor.

27

[QUOTE=picunurse]
One other use that has fallen out of favor (for obvious reasons) was slowing permature labor.
[/QUOTE]

:eek:

how? I mean, how did it help to slow labour? Isn’t premature birth one of the consequences of alcohol abuse during pregnancy?

28

[QUOTE=picunurse]

I once cared for a Somoan gentleman who was 6’7" and weighed more than 500 lbs. His BA was the highest ever seen in our hospital.
[/quote]

You can’t do this to us. Please, think of the children.

How high was it?

29

[QUOTE=ForumBot]
You can’t do this to us. Please, think of the children.

How high was it?
[/QUOTE]

I don’t remember exactly, but it was over 0.60. I don’t think it it was as high as 0.70, though.