BAC of .53

[emt322632]

I had never seen, let alone heard of ANYTHING this bad until yesterday...

2 college kids went on a drinking binge, one was totally unresponsive without a gag reflex and around 6-8 resps/min, the other was singing and having a jolly time.

The unresponsive kid ended up having a BAC of .53, now on a ventilator...

Anyone else ever run into BACs that high before? If so what was the patient outcome in the long run? I'm thinkin if this kid survives, he's having permanent brain or liver damage...

[Ridryder 911]

Yep....Alcohol toxicity even seen them die with it. Welcome to emergency medicine..

R/r 911

[Richard B the EMT]

Did the one who was conscious have previous "experience" with drinking? One of the outlawed campus "events" has been binge drinking in frat (and sorority) houses, for kids who may have never drunk any alcohol before in their lives. Yes, alcohol poisoning remains a big campus problem.

[emt322632]

ACtually yes the one that was conscious was hospitalized 2x previously for alcohol poisoning.

Found out today that the unconscious one removed his own tube today...hopefully he learned a lesson, albeit the hard way...

[FormerEMSLT297]

The highest I have ever seen it in the field I think was the high .3x or I think low .4x.... but like I said in a previous post, these people were all driving...

But .53 is a very high number.....

Thats amazing.

We did lock up a girl who was like 23-24 and she was a .38 at 5 PM on a weekday afternoon.

Think she had a drinking problem???

[chbare]

This finding is pretty common among the clients that utilize the emergency medical services of our nation. I have seen "Professional" drinkers that have levels in the 400's, and these people are ambulatory, ao times3, and have clear speech. This topic does create some interesting discussion on the effects of acute alcohol intoxication. In the "alcohol naive" patient you need to worry about a couple of things. First, we all know about the depressant effects of alcohol on the CNS and the danger of hypoventilation, loss of airway reflexes, and aspiration risk. In addition, we need to worry about another problem. High levels of alcohol in the body can also prevent our hemoglobin from properly loading, transporting, and offloading oxygen. This is known as histotoxic hypoxia. The red blood cells are essentially poisoned and unable to effectively function in the transport of oxygen. We usually associate histotoxic hypoxia with other problems such as cyanide exposure; however, it is possible with alcohol intoxication. This can result in continued hypoxia even after an airway is secured and the patient is on a vent. So, we can see how long term problems such as, cerebral hypoxia can still occur even with adequate airway management techniques.

Take care,

chbare.

[AZCEP]

Work on a reservation for a few weeks.

These two are rank amateurs compared to some locally. I've transported patients with BAC's >600 that were having lucid conversations with me at 1100. BA of >500 and BGL >500 is not the least bit uncommon.

"Help, I've got blood in my alcohol stream!"

[Dustdevil]

Work on a reservation for a few weeks.

Exactly what I was thinking!

Usually, you only see this sort of high level intoxication at EMS parties. :?

[becksdad]

Addictions are a HUGE problem everywhere, I think. This poses a challenge to us as EMS providers because it is so prevalent, especially poly-pharmaceutical abuse.

The most wasted person I have ever seen presented to our ER a few weeks ago. He had a BA in the low 500's, and EMS brought with them 3 empty Rx vials - Percocet 10's #30 ( not 5's, 10's ), Diazepam 5's #30, and Ambien 10's #20. All dated within the last 3 days. According to "significant others", this patient had consumed all of these himself, as well as 2 GALLONS of Vodka in the last 48 hours.

This patient was initially found face down in a pool of coffee-ground emesis, and was covered in bloody vomit from chin to waist. Believe it or not, this person could tell you his name, birthdate, the year, the date, the current president, where he was, and what happened. Once you translated through the gibberish talk and unfocused eyes, that is. Amazing. It must be a full-time job to develop that kind of tolerance.

Just as a footnote, this patient did NOT have esophageal varices, the entire time he was in the ER his V/S remained WNL (R/R between 14-18, P=in the 80's, and BP in the 130's systolic). Temp. just a little low initially (around 97.0). Again, amazing. A few days later he walked out of the hospital under his own power, entering an in-patient treatment program.

I do not volunteer this story as anything like one-upmanship, but to raise awareness of the immense problem of poly-addiction, and the true medical emergencies that this can present.

[strippel]

I have never seen any above 500, but many in the upper 4s, especially when I worked in the ER.

We used to, and still do take bets. Last week, we had a guy who drove into the back of a stopped school bus. He was fully alert and oriented, and even tried to stop for the bus. Thank God it wasn't loaded. He said it shouldn't have been stopped in his lane (bus was waiting to turn left).

He was .382, at 1000 AM.