Doctors save man with vodka drip

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Australian doctors saved a man from ethylene glycol poisoning by giving him a vodka drip at a rate of three standard drinks per hour for three days.

http://news.bbc.co.uk/2/hi/asia-pacific/7037443.stm

That should be enough alcohol to kill any person in good health. Can someone explain to me why vodka didn't kill him but saved his life?

I thought I'd get a better response in the med forum.

 

[soonereng]

That should be enough alcohol to kill any person in good health. Can someone explain to me why vodka didn't kill him but saved his life?

If I remember correctly it is because alcohol dehydrogenase has a higher affinity for ethanol than ethylene glycol which prevents the metabolism of the antifreeze which would have greater adverse effects than the ethanol. Also the side effects of the ethanol can be treated too.

Edit: Check out this link.

 

[want2beadoc]

IV loading dose: 7.6-10 mL/kg IV of 10% ethanol (V/V) in dextrose 5% in water over 30 min to achieve blood ETOH concentration of 100-130 mg/dL (21.7-28.2 mmol/L)
Oral loading dose: 0.8-1 mL/kg PO of 95% ethanol in 6 oz of orange juice over 30 min
Average maintenance doses (PO/IV): 0.15 mL/kg/h PO of 95% ETOH; 1.4 mL/kg/h IV of a 10% solution

Thats the Emedicine recommended treatment. I don't thinks thats equating too close to three standard drinks (Wikipedia says that the standard drink of australia is 12.7 ml). 3 times that would equal 40.1 ml of 95% ethanol. A 100 kg man would require a maintenance dose of 15 ml / hr PO of 95% ethanol if I'm reading that right (I'm a second year, I don't know real medicine).

I'm too tired to check my numbers so tell me if I'm wrong.

 

[soonereng]

IV loading dose: 7.6-10 mL/kg IV of 10% ethanol (V/V) in dextrose 5% in water over 30 min to achieve blood ETOH concentration of 100-130 mg/dL (21.7-28.2 mmol/L)
Oral loading dose: 0.8-1 mL/kg PO of 95% ethanol in 6 oz of orange juice over 30 min
Average maintenance doses (PO/IV): 0.15 mL/kg/h PO of 95% ETOH; 1.4 mL/kg/h IV of a 10% solution

Thats the Emedicine recommended treatment. I don't thinks thats equating too close to three standard drinks (Wikipedia says that the standard drink of australia is 12.7 ml). 3 times that would equal 40.1 ml of 95% ethanol. A 100 kg man would require a maintenance dose of 15 ml / hr PO of 95% ethanol if I'm reading that right (I'm a second year, I don't know real medicine).

I'm too tired to check my numbers so tell me if I'm wrong.

Your numbers look right. It didn't say how much this man weighed. Perhaps he was a very large man, or the doctor doesn't know how much a standard drink is.

Either way, the point is that the ethanol prevents the antifreeze from being metabolized and doing bad things.

 

[Flopotomist]

Australian doctors saved a man from ethylene glycol poisoning by giving him a vodka drip at a rate of three standard drinks per hour for three days.

http://news.bbc.co.uk/2/hi/asia-pacific/7037443.stm

That should be enough alcohol to kill any person in good health. Can someone explain to me why vodka didn't kill him but saved his life?

I thought I'd get a better response in the med forum.

The answer with the alcohol dehydrogenase seems to make the most sense. The reason a larger than normal dose of EtOH wouldn't kill a patient in the short term in a hospital setting is because of the ability you have to control respiratory drive, and protect the airway.

 

[cbrons]

thats pretty amazing. I read this post earlier then came across the house episode from last year about the death row inmate who drank all methanol to try and kill himself and house got a bottle of vodka and they drank together.

 

[mints of b]

Does this mean hospitals stock vodka?

 

[psychoandy]

Does this mean hospitals stock vodka?

You'd be surprised what a hospital's dietary department has.

Plus pharmacy has pure 95% EtOH...for medical/research purposes of course...

 

[OB1🤙]

Many (if not most), yeah. Vodka or beer. You order it from the pharmacy.

Seriously.

 

[mints of b]

Funny. What kind of beer?

 

[jdh71]

Funny. What kind of beer?

I've seen warm budweiser

 

[mints of b]

I've seen warm budweiser

You learn something new every day.

BTW, there's something poetic about that sentence.

 

[aussie princess]

We can be resourceful down here when we need to be 😉

As for standard drinks in Australia it is equal to 10g of pure alcohol which is:


30mL (standard shot glass) of spirits
100mL standard table wine
375mL (3/4 of a stubby) of regular beer... and the list goes on. 🙂

 

[DeadCactus]

On a similar topic; a friend claims his father was in the hospital detoxing from alcohol and was given a vodka drip. I just blew it off as him being an idiot (to be fair, he's not the brightest bulb in my group of friends); but now I'm curious if there might be some truth to his story...

 

[MattD]

On a similar topic; a friend claims his father was in the hospital detoxing from alcohol and was given a vodka drip. I just blew it off as him being an idiot (to be fair, he's not the brightest bulb in my group of friends); but now I'm curious if there might be some truth to his story...

From what I can understand DT's from EtOH are pretty harsh, I can imagine that being a true story to help him come down if he was a particularly hard core alcoholic.

 

[brianmartin]

Reminds me of a story I heard, where a man decided to drink some antifreeze because "it was too cold outside." This was in a tiny town up in Alaska somewhere. The local "doc" didn't know what to do so they called a consult. Advice was to "get the man a bottle of Jack Daniels, STAT." "Uh oh" says the doc, "this town is dry."

 

[Ashers]

I've seen warm budweiser

When I was in the NeuroICU, one of our patients got 2 beers with every meal because he was such an alcoholic.

My dad was just telling me that in the 70s and 80s they used to use alcohol as a tocolytic, so my mom decided to drink a lot of sherry to stop labor when my dad was in surgery and wouldn't have been able to make it for my brother's birth.

 

[Lshapley]

Detox is pretty harsh. Saw a medical examiner's show (I'm just a pre-med, so discovery health is often the best I can do 🙂 )where a severe alcoholic went on a cruise with his ex-wife on the condition that he didn't drink. He kept up his end of the bargain...and died while on the cruise as a direct result!

 

[tacrum43]

thats pretty amazing. I read this post earlier then came across the house episode from last year about the death row inmate who drank all methanol to try and kill himself and house got a bottle of vodka and they drank together.

ER had an episode (in one of the first few seasons) where they had a patient who had ingested anti-freeze and they ran out of IV ethanol. So, they just gave him shooters from the bourbon bottle they confiscated from a homeless man in the ER.

I 😍 ER.

 

[TerraMedicX]

Yes, the answer is in fact that the liver (via alcohol dehydrogenase) preferentially metabolizes ethanol over any other alcohols (ethylene glycol, methanol, etc). It is not actually the toxic alcohols that damage the body, but rather their metabolites, so by maintained a constant level of ethanol in the body, it keeps the liver busy until the kidneys can filter out the toxic alcohols. A "vodka drip," is somewhat misleading as hospitals will generally use a pharmaceutical grade pure ethanol. There are, however, ambulance services that cary everclear, vodka or other high % alcohols along with their narcotics for treatment of toxic alcohol ingestions. I actually had this presented to me for my final verbal exam in paramedic school, only three of us remembered to give the 3 year old a drink! 😎

Nate.

 

[Blade28]

I've had to write for beer, 1 can, 12 oz, Q12H a couple times for alcoholic inpatients. Nice. 🙂

 

[finallyMS3]

I've had to write for beer, 1 can, 12 oz, Q12H a couple times for alcoholic inpatients. Nice. 🙂

serious? all we ever seem to do is give them librium/ativan, thiamine, folate, and maybe B12.

 

[Blade28]

serious? all we ever seem to do is give them librium/ativan, thiamine, folate, and maybe B12.

Yeah, we don't use Librium at our county hospital anymore.

Beer works wonders!

 

[PeepshowJohnny]

I believe our hospital stocks a case every once in a while because they get an alcoholic who comes in with something else and becomes beligerent. If they're worried about him going into DT's and he's starting to act threatening or wanting to go AM, they gave him the beers to calm him down. It's very rare but apparently they've used it in the past and advise the residents on it.

 

[LJDHC05]

We can be resourceful down here when we need to be 😉

As for standard drinks in Australia it is equal to 10g of pure alcohol which is:


30mL (standard shot glass) of spirits
100mL standard table wine
375mL (3/4 of a stubby) of regular beer... and the list goes on. 🙂

I could see walking into the local establishment and asking for a stubby of regular beer...and being tossed promptly out on my arse

 

[fun8stuff]

Yeah, we don't use Librium at our county hospital anymore.

Beer works wonders!

cheaper!

so my dad claims after having shoulder surgery (back in the '70s) a nurse would bring him beer at night. it was only the 3rd shift nurse that did it. no, he wasnt an alcoholic either...