ALCOHOL, abuse and abstinence syndrome

Alcohol's pernicious side effects are due to abuse as well as sudden abstinence in someone who is used to excessive consumption.

1. Alcohol abuse
   
   Drinking excessive alcohol may put a person in a critical state, either because they have absorbed a toxic amount of alcohol or due to accidents which can occur in such state.
   
   Alcohol abuse signs vary according to the amount consumed. They range from an ordinary drunkenness state to a severe acute intoxication.
   
   In the state of ORDINARY DRUNKENNESS the individual has poor muscle control, has difficulty talking or walking properly and is unable to perform simple tasks. The face is red and the eyes are "injected with blood". There may be vomiting. Behaviour ranges from euphoria and happiness to aggressive behaviour, or even depression. Make sure there are no fractures or other lesions.
   
   Alcohol is toxic. When there is a large intake in a short time period, especially on an empty stomach, poisoning or SEVERE ACUTE INTOXICATION may occur, which may become lethal due to respiratory or cardiac failure. In such state the patient lies unconscious, with slow and noisy breathing, dilated pupils, fast pulse and livid lips; his breath smells of alcohol.
   
   When caring for a patient with alcohol abuse or abstinence syndrome there is a fundamental issue: THE PATIENT SHOULD NEVER BE ALONE, since there is a risk of going into an unconscious state, if not Anteriorly in it, and vomiting and aspirating the vomit, which may prove fatal.
   
   If the person is drunk but conscious, give 1 to 2 glasses of water to prevent the hangover caused by alcoholic dehydration and put to bed. Do not give anything to eat until recovered. Obviously, he should not drink alcohol. Classic discomfort due to HANGOVER (headache, generally unwell, stomach complaints) will be treated making the patient drink plenty of non alcoholic beverages and with paracetamol (DRAWER 3, first aid kits A, B and C), and if necessary, an antacid (algedrate + magnesium hydroxide, DRAWER 2, first aid kits A, B, and C), which will be given three times a day.
   
   If the patient is unconscious, the first approach is to check if there are respiratory movements and heartbeats, otherwise start cardiopulmonary resuscitation manoeuvres (refer to Chapter 1.2). If the patient starts to breathe, place in lateral recumbent position to avoid swallowing of own vomit (refer to Chapter 1.5). It is essential to ask for MEDICAL ADVICE VIA RADIO.
   
   
2. Alcohol abstinence syndrome
   
   When a person who has become alcohol dependent over a long period of time is deprived from it suddenly, two situations may occur: one, milder, in which due to the lack of consumption hand tremors appear, body shakes and sweating, especially in the morning. The patient in this case usually decides his own treatment by taking another drink.
   
   The most dangerous situation due to alcohol deprivation is DELIRIUM TREMENS, characterized by severe mental and emotional disturbance (hallucinations), with tremors, profuse sweating and fever (up to 39ºC). This is a serious life threatening medical emergency.
   
   In case of severe abstinence syndrome the patient should be isolated and cared for as soon as possible; the room illumination will be reduced to a minimum to avoid visual hallucinations. Try to offer plenty of sweet drinks, and if the patient wants to eat, food should be provided. Specifically, try to calm the patient with a glass (50 ml.) of whisky or its wine equivalent; inject 50 mg. of chlorpromazine intramuscularly (DRAWER 4, first aid kits A and B), and then give him 10 mg. orally every 4 hours until the patient relaxes. Once the treatment has started do not give any more alcohol. Due to the potential severity of this condition it is necessary to ask for MEDICAL ADVICE VIA RADIO .