Tuesday, January 09, 2007 Alcohol intoxication or poisoning in kids
ETHANOL is the common cause of alcohol intoxication or poisoning. It is mostly present in alcoholic beverages, over the counter medications and cold preparations.
Methanol is the most lethal of the alcohols. It can cause permanent blindness and present in windshield wiper and cleaning fluids.
Isopropyl alcohol is less toxic but causes significant irritation of the stomach. It is commonly present in rubbing alcohol and jewelry cleaning fluids.
Alcohol intoxication is the ingestion of toxic quantities of ethanol. Ingestion of one gram per kilogram body weight will yield peak blood levels of 100 milligrams of alcohol per 100 milliliters of blood, the legal limit defining intoxication.
Alcohol intoxication is widespread among children but the actual incidence is not known. It can affect children and adults of all ages. There is no sex or race predilection.
Hard liquor contains 20-50 percent alcohol, wine 10-14 percent, and beer 3-8 percent. Alcohol is also present in cold medications 2-25 percent, mouthwashes 7-27 percent, rubbing alcohol 70 percent, after shave lotions 15-80 percent, and perfumes or colognes 25-95 percent. One percent is equivalent to one milligram per 100 milliliter.
The concentration maybe expressed as proof, which is equal to twice the percentage of ethanol.
Ethanol is rapidly absorbed (20 percent in the stomach, 80 percent in the small intestines). Blood level is detected 10 minutes after ingestion and expected to peak in 20-30 minutes. Two to three per cent of the alcohol ingested is excreted unchanged by the kidneys to the urine.
In pregnant women rapid absorption of alcohol into the maternal circulation is rapidly distributed into the blood of the unborn baby where it exert its adverse effects. Infants born to mothers who have been drinking alcohol immediately before delivery may develop withdrawal symptoms such as agitation, hyperactivity, marked tremors and convulsions.
These symptoms usually last for 72 hours followed by 48 hours of lethargy (physical and mental sluggishness).
Lactating mothers who ingest alcohol secrete the substance in the breast milk. It affects the odor of the milk as well as the feeding behavior of the infant mostly reduction of the milk intake.
Reduction of the intake maybe due to change of the flavor of the milk or from the effects of alcohol on the baby or a decrease in milk production of the mother. Sucking is usually increased temporarily.
The baby sleeps more, but for shorter periods. Accidental alcohol intoxication occurs frequently in young children. Most often the source of alcohol are beverages that are within the child's reach left out after parties. Some infants are given by caregivers over the counter cold remedies that contain alcohol.
Friendly neighbors may misinform parents on how to treat teething and infant colic with alcohol. Putting several drops of hard liquor (brandy or rhum) in the infant's mouth for teething or adding the liquor to the milk formula to treat colic.
Alcohol can be absorbed through the skin and cause intoxication. This can happen when a caregiver gives the child undiluted alcohol bath to treat high fever.
Another source of alcohol intoxication is accidental ingestion of perfume or colognes, mouthwashes or cleaning fluids. Sometimes the liquid ingested may contain other chemicals that are more toxic than alcohol.
Alcohol intoxication in adolescents are often intentional as a response to stressful home environment, peer pressure, or to imitate a parent alcoholic. Sometimes an adolescent ingests large amounts of alcohol as part of his attempt to commit suicide.
The effects of alcohol depend upon the amount ingested. In small amounts alcohol acts either as a stimulant or as a relaxant. In moderate amounts, alcohol is a central nervous system (CNS) depressant.
It causes decreased mental function, impaired judgment, slurred speech, unsteady movements and staggers when walking. In moderately large amounts alcohol produces lethargy (mental and physical sluggishness), reduced ability to respond to stimulation and eventually the individual losses consciousness.
Ethanol causes low blood sugar with convulsions as a major manifestation in children. We have seen several infants and young children convulsing because their drunken fathers gave their children tuba (coconut palm wine) or rhum to stop the crying. Other complications include vomiting with aspiration of the stomach contents to the lungs, low blood pressure, increase urinary losses and dehydration (effects of fluid loss).
Rapid ingestion of large amounts of alcohol is considered a medical emergency that leads to respiratory failure and death. In ethanol intoxication, survival is expected with treatment if blood levels of alcohol are less than 300 milligrams per 100 milliliter of blood. The risk of death is expected if a blood level of alcohol is greater than 500 milligrams per 100 milliliters of blood despite treatment.
Prevention of alcohol intoxication consists of keeping all alcohol containing fluids out of reach of children and disposing unfinished alcoholic beverages after parties. This also involves the use of safety caps on bottles and locks on medicine and liquor cabinets. Avoid purchasing medicines containing alcohol for use by children. Alcohol has no place in the treatment of teething and colic or to stop the baby from crying. If ingestion of alcohol was intentional, psychiatric evaluation is highly recommended. If ingestion was accidental parental education about child safety is required. (PVI)
