Go For the Gold

A 44-year-old-man with a past medical history of alcohol abuse was brought to the emergency department by EMS. He was found sleeping on a bench and appeared intoxicated. His initial vital signs were temperature 90.9°F, heart rate 62 bpm, blood pressure 130/84 mm Hg, respiratory rate 16 bpm, and pulse oximetry 98% on room air. He is disheveled patient, and has a depressed level of consciousness, slurred speech, and the distinct odor of mint and urine. Pertinent lab findings include an ethanol level of 340 mg/dL.   The minty odor is tipoff in this case that he is inebriated from mouthwash. The ethanol concentration in mouthwashes commercially available in the United States varies widely. The highest ethanol concentration reported is 26.9%. Alcohol-free products are also available.       The risk of toxicity from the nonalcoholic ingredients is minimal in most ingestions of mouthwash:     One standard drink is equivalent to 2.2 fluid ounces of 27% alcohol/volume mouthwash:   National Institute on Alcohol Abuse and Alcoholism; http://1.usa.gov/12ifXGW.   It is important to recognize the signs of ethanol intoxication in patients who have ingested any alcohol-containing mouthwash. Management strategies for ethanol-intoxicated patients are: n  Supportive care is the mainstay of treatment. n  Exclude other causes of altered mental status such as hypoglycemia, trauma, infection, co-ingestants, and stroke. n  Evaluate and treat complications of ethanol i...
Source: The Tox Cave - Category: Emergency Medicine Tags: Blog Posts Source Type: blogs