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D5 1/2 NS for hangover...


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The electrolytes and fluids in the banana bag are a no brainer. When you drink alcohol, you tend to get dehydrated (aka the morning hangover headache) and your electrolytes get goofy.

As for the vitamins... B vitamins are good for helping your body recover from any sort of insult, no? Generally those who have been out drinking (either short term binge or chronic abuse) have not been eating well while they've been drinking, so vitamin deficiencies aren't to be unexpected. It's going to be worse in your chronic alcoholic, but it surely can't hurt in your garden variety frat boy type.

Anyone got anything more specific than that? That's just what occurred to me as I sat down and thought about it (haven't had the chance to JFGI yet).

Wendy

CO EMT-B

I think what you will find is that Vit. B12, folate, and thiamine are the deficient vitamins in alcoholics to know.

In the case of B12 owing to decreased absorption from the gut in the presence of alcohol.

A normal person has a weeks of folate reserves and at least a few months of B12 reserves, so the benefit of vitamins in a non-chronic-alcoholic are questionable. However, as previously mentioned, it isnt going to hurt. The clinical manifestations of B12 deficiency (and folate deficiency because they are both involved in similar biochemistry) is typically megaloblastic anemia (anemia with big fat red cells) but can also lead to Subacute Combined Degeneration...basically a neurological condition which typically starts with balance issues due to damage to the nerves in the spinal cord that connect the cerebellum to the rest of the body.

Thiamine deficiency is thought to be involved in the pathogenesis of Wernicke-Korsakoff syndrome. This is essentially a syndrome of psychosis with balance and tremor issues (cerebellar issues if you will).

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So in the trials that they did with fetal rats and cerebellar malformation due to alcohol exposure... I wonder if B vitamins would have changed or fixed anything! Hm...

Wendy

CO EMT-B

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Thiamine deficiency is thought to be involved in the pathogenesis of Wernicke-Korsakoff syndrome. This is essentially a syndrome of psychosis with balance and tremor issues (cerebellar issues if you will).

You're forgetting probably the most terrifying [from the outside looking in at least]. The loss of ability to consolidate new memories via lesion of the mammillary bodies. Essentially, you can remember what you did 5 seconds ago, but you can't remember what you did 5 minutes ago.

Thiamine is also used in a bunch of cellular reactions (cofactor for dehydrongenase].

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When I first started working Penn State football games I was on a medic unit dispatched to one of the parking lots for a 23 year old male unconscious. When we arrived we found this guy unconscious as dispatched. His friends all swore he only had two beers and there must be something really wrong with him. They also identified themselves as paramedics and nurses from a large city. I was skeptical about the two beers but decided to give them the benefit of the doubt. We loaded him into the truck but needed the police to keep them from getting into the truck. High flow oxygen, nasal airway, glucose check, IV and narcan but he was still unconscious. We arrived at the local community hospital two miles away and I gave the ER staff my report. A nurse looked at me and said "Why the hell did you do all that treatment. He's drunk." She went on to say the only thing I did by giving fluids was to lessen the hangover. Their treatment for drunks is to put them in a room with a pulse oximeter and let them sleep it off.

I don't quite comprehend that philosophy but it turned out the guy's BAC came back at 250. I wouldn't treat the guy any differently even after working the games for ten years but I now ask how large were the two beers!

Live long and prosper.

Spock

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When I first started working Penn State football games I was on a medic unit dispatched to one of the parking lots for a 23 year old male unconscious. When we arrived we found this guy unconscious as dispatched. His friends all swore he only had two beers and there must be something really wrong with him. They also identified themselves as paramedics and nurses from a large city. I was skeptical about the two beers but decided to give them the benefit of the doubt. We loaded him into the truck but needed the police to keep them from getting into the truck. High flow oxygen, nasal airway, glucose check, IV and narcan but he was still unconscious. We arrived at the local community hospital two miles away and I gave the ER staff my report. A nurse looked at me and said "Why the hell did you do all that treatment. He's drunk." She went on to say the only thing I did by giving fluids was to lessen the hangover. Their treatment for drunks is to put them in a room with a pulse oximeter and let them sleep it off.

I don't quite comprehend that philosophy but it turned out the guy's BAC came back at 250. I wouldn't treat the guy any differently even after working the games for ten years but I now ask how large were the two beers!

Live long and prosper.

Spock

How did this nurse know that he was "just drunk"? Did the nurse expect you to do labs on the scene? Unconscious patient....sounds like you did everything right. I guess you could have left him knocked out and come back the next to pick up the body when he aspirates vomit. A bac of .25 is a solid buzz but everybody is different...I label this guy a buzz kill for making them call 911

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I never started an IV for my drunken escapades.

I have, however, started my own IV when the stomach flu almost killed me. I swear it did! At least, that's how I felt anyway... I couldn't keep water down. 2 liters later I felt like a new man. Minus the recurrent vomiting...

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