Methyl alcohol poisoning - causes, symptoms, diagnosis and treatment

Alcohol poisoning is a complex of symptoms of poisoning when the main toxic substance is alcohol and its metabolites. In addition to ethyl alcohol, methyl, butyl, isopropyl and other alcohols, the toxic effect of which, as a rule, is even more pronounced, can enter a person.

First of all, in terms of danger, acute alcohol poisoning should be highlighted, which usually occurs due to an overdose of strong alcoholic beverages or the use of alcohol substitutes. True, when taking alcoholic surrogates, poisoning ceases to be purely alcoholic, since the surrogate used as an alcohol substitute contains, in addition to ethyl alcohol, other poisons - usually methyl alcohol, acetone and others. One of the first places in the statistics of household poisonings is occupied by poisoning with surrogates or low-quality alcohol.

Symptoms of alcohol poisoning

Signs of the toxic effects of alcoholic beverages appear gradually. The severity of symptoms of alcohol poisoning changes in accordance with the increase in the concentration of ethyl alcohol in the blood plasma. Poisoning with alcohol surrogates occupies a leading position in the statistics of all intoxications. Moreover, 98% of patients die before hospitalization. A brief description of the alcohol surrogate will help to understand the reason for such a high mortality rate. What are alcohol surrogates? What are the signs of poisoning with such counterfeit alcohol? How to help the victim? What could be the consequences of such intoxication? We will look at the answers to these questions in this article.

What applies to alcohol surrogates?

Poisoning with alcohol substitutes in the international classification of diseases ICD-10 corresponds to codes T51.1 - T52.9. They are divided into two groups: those alcohol substitutes that may contain ethyl alcohol and those that may not contain it. The first group includes: 1. Butyl alcohol. Death occurs after taking just 30 milliliters. 2. Hydrolysis and sulfite alcohols, which are obtained from wood. They are more toxic than ethanol due to the presence of a small amount of methyl alcohol. 3. Denatured alcohol or technical alcohol. Contains some wood alcohol and aldehyde. 4. Colognes and lotions. They may contain up to 60% ethanol. 5. The polish contains several types of toxic alcohols. 6. The stain, together with ethanol, contains dyes, which cause the patient’s skin and mucous membranes to turn blue.

The second group, or they are also called “false surrogates,” is represented by: • methyl alcohol; • ethylene glycol.

Diagnostics

Diagnostic criteria

· The main sign of poisoning is metabolic acidosis with increased values of osmolality gap and anion gap.

· Symptoms appear late, no earlier than after 15-20 hours, hyperventilation and visual disturbances appear.

· If there is combined consumption of wood alcohol and ethanol, it may take several days after ingestion before feeling unwell.

· Other symptoms include nausea, vomiting and headache.

· In the most severe cases, blindness, coma and respiratory arrest occur.

History taking

What questions should you ask the patient:

Amount and concentration of the substance used?
Time aspect?
Did the patient influence consumption by inducing vomiting or using sorbents?
Was the person taking other pills or medications? What and how much?
Could others ingest the same alcohol and accidentally become poisoned?
Does the patient have chronic problems with alcohol ? Alcoholics can tolerate more methanol before poisoning.

It is worth considering that poisoning can also occur in industrial companies through absorption through the skin or inhalation.

Clinical data

· Various degrees of decreased consciousness.

· Hyperventilation. As a rule, it is first observed in the later stages.

· Possibly fluctuating abdominal pressure.

· Coma, cyanosis.

· Ophthalmoscopy: poor reaction of the pupil to light, retinal hyperemia with inflammation.

· Blurred edges of the papilla without protrusion, the so-called pseudo papillitis.

Additional Research

· Acid status/base.

· Metabolic acidosis.

· Electrolytes.

· Glucose.

· Urea.

· Serum amylase and possibly serum lipase for the development of pancreatitis.

· Determination of methanol in blood and urine.

· In cases of severe poisoning, a CT scan of the brain (possibly an MRI) may be indicated in later stages.

· Calculation of osmolal and anion gap. It has proven to be a reliable and very good diagnostic tool for methanol poisoning.

By calculating the osmolality gap and the anion gap, a diagnosis of methanol or ethylene glycol poisoning can be made with a high probability. The treatment is the same for both. Osmolality gap and anion gap are increased in methanol poisoning.

1. Early in the process, before methanol degradation has begun, the patient will have a high osmolality gap (lots of methanol) and usually anion gap (some formic acid) and slight acidosis. Such patients are usually not severe.

2. At the end of the process, when all the monohydric alcohol is decomposed, the value for the osmolality gap will be normal, while for the anion gap it will be high (lots of formic acid). These patients are often severe.

Symptoms of poisoning with surrogates containing ethyl alcohol

Clinically, signs of alcohol intoxication are first observed:

emotional and motor arousal;
facial redness;
state of euphoria;
sweating;
increased salivation;
a feeling of mental and physical relaxation.

Then intoxication gives way to symptoms of alcohol intoxication. The skin becomes pale. There is a frequent urge to urinate. The pupils dilate and the mouth feels dry. Increased mental and physical activity is accompanied by a lack of coordination, movements become sweeping. Concentration becomes reduced, speech is slurred. Criticism of one's words and actions is sharply reduced or completely absent.

Symptoms of methanol (wood alcohol) poisoning

Methyl alcohol is quickly absorbed in the digestive system. About 75% of the absorbed poison is excreted in the breath, the rest in the urine. The lethal dose ranges from 50 to 150 milliliters. The main impact of poisoning falls on the nervous system and kidneys. A psychotropic effect occurs (pathological changes in the psyche) and a neurotoxic effect, accompanied, among other things, by damage to the optic nerves and retina. So, when poisoning with alcohol surrogates containing methanol, the following symptoms occur:

nausea, vomiting;
intoxication and euphoria are weakly expressed;
visual impairment: flickering black dots before the eyes, blurred vision, diplopia (double vision) and even blindness;
outwardly, in such patients the pupils are dilated and react sluggishly to light;
1-2 days after poisoning, pain in the abdomen, lower back, aches in the muscles and joints appear;
the temperature rises to 38⁰;
dry skin and mucous membranes;
low blood pressure;
interruptions in heart function;
confusion;
attacks of excitement accompanied by convulsions;
As the symptoms increase, the victim falls into a coma and paralysis of the limbs develops.

Prognosis for recovery

The most optimistic prognosis is when drinking ethyl alcohol. However, the outcome largely depends on the dose of alcohol and timely assistance provided. With regular alcohol consumption, liver destruction, gastrointestinal diseases, neurological and mental disorders are inevitable. The most severe consequences are poisoning with methyl alcohol or ethylene glycol. These are blindness, cirrhosis of the liver, gastritis, ulcers, kidney failure. Disability or even death of a person are common consequences of using a surrogate. In order not to endanger your life, you should drink only high-quality and licensed alcohol.

Symptoms of ethylene glycol poisoning

Ethylene glycol is also quickly absorbed in the digestive tract. About 60% of the poison is broken down in the liver, about 20–30% is excreted by the kidneys. Therefore, it is these organs that will suffer the most, up to the development of their acute failure. In severe poisoning, signs of damage to the nervous system appear. When intoxicated with this alcohol substitute, symptoms develop over periods.

Early period. It lasts about 12 hours and is characterized by signs of alcohol intoxication while feeling well.
Toxic damage to the nervous system. There are: nausea, vomiting, headache, thirst, diarrhea, skin and mucous membranes become cyanotic. The pupils are dilated, body temperature rises, difficulty breathing, tachycardia, and psychomotor agitation appear. Loss of consciousness with the development of convulsions is possible.
The nephro and hepatotoxic period develops 2–5 days from the onset of the disease. A clinical picture of liver and kidney failure is noted. Yellowness of the skin appears, which appears first on the sclera and last of all, the palms turn yellow. Skin itching is characteristic, and darkening of the urine may occur. Renal failure is manifested by a decrease in diuresis up to its absence.

General primary external signs

First of all, motor emotional and arousal arises. As a rule, this is accompanied by liveliness (a characteristic sparkle in the eyes). The initial euphoria is perceived as a pleasant elevation above life's problems. The attitude towards yourself and others changes. This is how a person begins to talk more, and his statements become categorical. When drinking strong drinks, hyperemia (redness) of the skin is observed. This change is usually more pronounced in the upper part of the body, especially on the face; dilation of the pupils is clearly noticeable.

Common secondary signs of poisoning

Subsequently, an increase in the concentration of alcohol when it is absorbed from the stomach into the blood has an increasingly stronger effect on the central nervous system and disrupts the control and regulatory function of the brain. Here symptoms of complete disinhibition are already appearing. A drunk person begins to exhibit instinctive behavior: stupidity appears in judgments, overt sexuality and (or) aggressiveness in behavior. At this same stage of intoxication, awkwardness of movements is observed. Violation of the coordination of motor regulation is caused by the effect of alcohol on the cerebellum. Increased motor activity as ethanol is absorbed quite soon gives way to awkwardness, a “drunk gait” and other characteristic symptoms.

Severe symptoms of poisoning

The vast majority of symptoms of alcohol poisoning are caused by the neurotoxic effects of ethyl alcohol. General toxicity is much less pronounced in the first hours after consumption. That is why the dangerous symptoms of severe poisoning are of a neuroparalytic nature.

Ethanol molecules, due to their minimal sizes relative to other organic compounds, have a unique penetrating ability. So they easily pass the blood-brain barrier. In this case, damage occurs to both the structure of the neocortex and the impact on the centers of the peripheral autonomic nervous system.

Therefore, severe alcohol poisoning is always accompanied by disruption of the vascular and respiratory centers of the central nervous system. With a serious concentration of neurotoxic poison in the body, depressive symptoms from alcohol clearly appear. Outwardly, this easily manifests itself in speech and motor activity. Speech and movements when reaching a severe stage of intoxication become meaningless and incoherent. Therefore, a drunk person, or in fact seriously poisoned by alcohol, is “not able to cope” and can only move by crawling. As alcohol intoxication increases, alcohol stunner quickly develops. A person loses the ability to perceive reality and respond to irritation. Here, in addition to these obvious dangerous symptoms, an alcoholic coma can develop, with all the ensuing consequences.

Removing alcohol intoxication

The intervention of a narcologist requires moderate and severe degrees of alcohol poisoning, and in the latter case hospitalization is indicated. To treat intoxication, a detoxification drip with electrolyte solutions is placed to correct fluid deficiency, metabolism, and water-salt balance. Additionally, medications are used to eliminate the consequences of severe intoxication. This:

hepatoprotectors;
drugs to improve blood circulation, cognitive abilities, and prevent further hypoxia;
means for stabilizing blood pressure and heart rate;
painkillers;
sedatives.

But it is possible to determine exactly how to relieve alcohol intoxication only after a preliminary assessment of the patient’s condition and clarification of possible contraindications to the use of certain medications. If help is provided at home, an ECG is taken, neurological reflexes are checked, heart and breathing sounds are auscultated, blood pressure, pulse, and saturation are measured.

In the hospital there are much more opportunities to solve the problem of how to relieve the symptoms of acute ethanol poisoning. All necessary medications are administered almost around the clock, and drug treatment is supplemented with hardware cleansing.

Single episodes of moderate intoxication are quite normal for an adult. But if such cases become more frequent, you should consult a doctor as soon as possible. Chronic alcohol intoxication is fraught with very serious consequences. These are not only complications from internal organs, but also irreversible personality changes. This condition requires complex, long-term treatment, and we are talking not only about the use of medications, but also about psychotherapy, physiotherapy and other methods of getting rid of alcohol addiction.

What types of alcohol surrogates are there?

Alcohol surrogates include various liquids in which, in addition to ethyl alcohol itself, there are other non-food components (BF glue, denatured alcohol, lotions, colognes, hygiene products, etc.), as well as other highly toxic alcohols (wood alcohol, ethanol, antifreeze, ethylene glycol, brake fluid and other technical fluids). Chronic poisoning of the body with alcoholic beverages is usually observed when alcohol dependence is not only already formed, but also progresses. Here you can read about the consequences of constant alcohol abuse, because this is a topic for a separate article.

Pure alcohol from distillation columns is also used for pharmaceutical and medical purposes and is included in many liquids. Therefore, poisoning is possible not only with liquids for technical purposes, but, for example, with sanitary and hygienic products and perfumes. As an illustration of the latter, inexpensive colognes can be mentioned. Although such products cannot be strictly classified as alcohol surrogates, intoxication from them is very similar in symptoms and consequences.

What is methanol and what is the mechanism of its toxic effect on the body?

Methanol is a monohydric alcohol with the chemical formula CH3OH. Widely used in the chemical, gas and pharmaceutical industries, it is part of antifreeze, solvents, glass cleaners, liquid fuels, and gasoline additives. It is a transparent, colorless liquid with a specific odor and taste similar to ethyl alcohol. They can only be distinguished experimentally using hot copper wire. It is immersed in the test liquid. If it is methanol, an unpleasant and pungent odor appears; if it is ethanol, the aroma of rotten apples appears. But it is unlikely that an alcoholic who wants to quickly “improve” his condition will conduct such tests. He will simply drink the obtained “treasure” and thereby doom himself to death. This is the main danger of the substance, since it is difficult to distinguish it from alcoholic beverages by appearance, smell and taste. Even 2% methanol content in the liquid you drink can be toxic. The lethal dose of methanol can vary depending on the individual characteristics of the organism - for one, 30 ml is enough, for another, it can survive even with a much larger amount of methanol taken. There is a known case where a person managed to survive after taking 500 ml of methanol.

For the average person, a dose of 100 ml of methanol is lethal. The lethal concentration in blood plasma is considered to be 1 g/l.

The risk group for methyl alcohol poisoning most often includes chronic alcoholics, into whose bodies it enters due to the use of surrogate drinks or substitution. In addition, persons engaged in the production of products containing methanol, as well as those using methanol-based solvents for washing glass inside cars or closed, small and poorly ventilated rooms, have a significant risk of poisoning through the skin and respiratory tract.

It is not so much methyl alcohol itself that is toxic, but the products of its metabolism - formaldehyde and formic acid. The latter is a powerful inhibitor of tissue respiration and the main cause of metabolic acidosis (a shift in the pH of biological fluids to the acidic side). The main toxic effect is on the nervous, cardiovascular and excretory systems. The insidiousness of methanol is that it is quickly absorbed, but very slowly eliminated from the body. The maximum concentration in the blood is observed 30–60 minutes after consumption, and elimination lasts for 3-5 and even 7 days. Moreover, during this time, methanol can be released by the gastric mucosa and reabsorbed.

Methyl alcohol is metabolized in the liver by the enzyme alcohol dehydrogenase, but more slowly than ethanol. It is this competitive interaction that makes ethyl alcohol the main antidote for methanol poisoning.

The main pathogenetic disorders in the body caused by methanol and the products of its biochemical transformation are manifested in the following phenomena: • Metabolic acidosis (increased acidity of the internal environment). • Decreased oxygen saturation of the blood.

In addition, methanol can accumulate (accumulate) in the body, which can cause chronic poisoning with the systematic intake of even small doses of this toxic substance.

What kind of alcohol are they poisoning with?

In addition to alcohol, which is clearly not intended for ingestion, poisoning with so-called “scorched vodka” often occurs. It can be quite difficult to distinguish licensed and counterfeit vodka by appearance. Moreover, there are numerous cases where similar products were sold in regular stores and even supermarkets of large retail chains.

To protect against this, as well as in an attempt to save money, people are increasingly resorting to moonshine. But even here, not everything is smooth and simple. Moonshine can contain a large amount of harmful impurities in the form of fusel oils. The consequences of consuming such a “homemade” product can also be very, very serious.

In addition to “palenka” and moonshine, the leading positions in the number of cases of poisoning include medical tinctures with alcohol. Alcohol tinctures of pepper and hawthorn are especially popular. Their use as an alternative to food alcohol in any long term leads to rapid social and mental degradation.

Poisoning after food alcohol may not appear immediately and may not be in an acute form; such poisoning can be treated in the usual ways, but if the signs described below are observed, special measures must be taken.

How to check the quality of vodka?

To prevent ethyl alcohol poisoning, you need to ensure the quality of the alcoholic drink before drinking it. The first test is carried out in the store before purchasing. All excise taxes and labels must be affixed to the bottle. If they are positioned crookedly or traces of repeated application are visually visible, then for your own safety it is better to refuse to purchase this type of bottle.

In addition, you need to pay attention to other important criteria that will help you choose a quality product. These include:

Cork. It should not idle. When the bottle is turned over, liquid does not leak through the leaky cap.
Price. Most often, counterfeit drinks are much cheaper. It's better to spend a little more money but buy better quality alcohol.
Content. There should be no sediment or foreign debris inside the bottle. If you shake the container in a spiral, you can see a snake of small air bubbles, which confirm the good quality of the drink.
Smell. After purchase, you need to open an unchilled bottle to smell its contents. Vodka should smell only of alcohol without any extraneous specific odors. If the aroma of the liquid resembles acetone or perfume, then it is better to avoid using this product.
Weight. The mass of a liter of pure vodka without a bottle is 953 grams. An error of 5-6 grams is allowed, up or down. If this value is very different, it means that the drink contains foreign impurities that can negatively affect human health in the future.
Freezing. The temperature in the freezer usually ranges from -18 to -25 degrees. If you place a bottle there, the good vodka inside will not freeze.
Setting fire. This method of checking the quality of vodka is called the old-fashioned method. It is considered one of the most effective. To carry out the experiment, you need to pour a little vodka into a tablespoon and hold it over the fire for a few seconds. If the liquid burns with an even blue flame, then the product is real and can be consumed. When a drink flares up sharply or does not light up at all, this indicates the presence of a surrogate in the composition.

To prevent signs of ethyl alcohol poisoning, you need to choose alcohol carefully But we should also not forget that long-term consumption of alcoholic beverages leads to the development of addiction.

Emergency care for poisoning with alcohol substitutes

If poisoning with alcohol substitutes is suspected, emergency care will depend on the initial condition of the patient. If the patient is unconscious, then he must be laid on a flat, hard surface, turn his head to the side to avoid aspiration of vomit and call an ambulance. If respiratory and cardiac activity is impaired, first call an ambulance, and then perform indirect cardiac massage and artificial respiration.

When the victim is conscious, first aid consists of the following:

take sorbent;
saline laxative;
drink an enveloping decoction, for example, jelly;
emergency hospitalization in a hospital.

Treatment of poisoning with alcohol surrogates in a hospital:

Gastric lavage through a tube. In case of methanol intoxication, it is repeated for 3 days. They give sorbents.
Antidote treatment in both cases is the same: five percent ethanol is administered intravenously. For mild poisoning, 30% ethyl alcohol can be taken orally.
In case of ethylene glycol poisoning, calcium gluconate is administered to neutralize the breakdown products of the toxic substance.
Forced diuresis is carried out, which is based on the drip administration of large amounts of solutions and diuretics in the absence of renal dysfunction.
Removal of toxins from the blood is also carried out by hemodialysis.
Glucose with novocaine, prednisolone, and vitamins B and C are administered.
In case of methanol poisoning, spinal punctures are performed.
In severe cases of ethylene glycol toxicity, a kidney transplant may be necessary.

Additional Information

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Types of coma after alcohol

In case of alcohol poisoning, three stages of coma are distinguished in accordance with the degree of severity.

Superficial coma, symptoms: constricted pupils, there is a reaction to light. When trying to bring the patient to ammonia, he reacts with defensive movements of his hands and a corresponding grimace, but does not come to his senses. To quickly bring the patient to consciousness, it is recommended to perform gastric lavage using a gastric tube; usually the prognosis is favorable.
Moderate severity, coma. Unlike the superficial one, there is a pronounced sign - relaxation of muscle tone. The patient reacts poorly to inhalation of ammonia vapor. There is no restoration of consciousness after gastric lavage. These symptoms require hospitalization to the toxicology department.
Deep coma. Tendon reflexes are completely absent. The pupils do not react to light, may be narrowed or wide with impaired breathing, and convulsions occur. There is no reaction to ammonia or pain sensitivity. Emergency immediate hospitalization to the toxicology department is indicated.

A comatose state from acute alcohol poisoning manifests itself externally in the following: the face becomes bluish and hypertrophied, the skin is sticky and cold, the pulse is weakened, thread-like, and breathing is intermittent and shallow. Such a critical condition of the patient requires the help of a resuscitator.

The likelihood of developing an alcoholic coma is especially high when an average-weight person, who usually rarely drinks, consumes the following dose of alcohol at one time or in a short period of time: 150-180 pure undiluted alcohol, or in terms of vodka 420-450 g, while creating alcohol concentration 0.3% or more.

Of course, if the indicated signs of alcohol poisoning are observed without first aid, alcohol poisoning can lead to death. What to do in case of alcohol poisoning, of course, provide first aid as quickly as possible. The lethal dose of alcohol is not constant and averages 5-13 grams of 96% alcohol per kilogram of weight. In alcoholics at the second stage, due to acquired tolerance to alcohol, the lethal dose is significantly increased compared to light drinkers and non-drinkers. Alcohol poisoning can result in the death of the victim, which occurs as a result of disruption of the cardiovascular system, respiratory arrest, hypothermia and other reasons.

Impact on the body

The influence of surrogates on the body has primary and secondary characteristics.

all starts with arousing the body on an emotional and physical level. The eyes begin to shine and activity increases. It seems that all problems have been solved, and the attitude towards the world around us is improving. At the same time, a person’s confidence in himself and his beliefs grows, he becomes sharp and categorical. If you start arguing with him, you will notice dilated pupils and redness of the face, which are also primary effects.

Some secondary signs cannot be noticed - this is the absorption of toxins into the blood, as a result of which the functioning of the central nervous system and brain is disrupted. Stronger alcohol intoxication occurs and the person clearly expresses the state: stupidity in judgment, aggressive behavior, sexual craving and others.

As the amount of toxins the body receives increases It becomes difficult to breathe, blood vessels narrow, speech and movements become inappropriate. This condition is characterized by crawling . With increasing intoxication, a person stops responding to everything and an alcoholic coma , which in turn can lead to death.

There are the following stages of coma:

The first is superficial . In order to bring a person to his senses, it is necessary to rinse the stomach.
The second is of medium severity. The main symptom is relaxed muscle tone. Gastric lavage will not revive the victim; hospitalization is required.
The third is a deep coma. There are no reflexes, no reaction to light, and convulsions may occur. Urgent medical attention is required.

A coma is most likely to occur if a person who rarely drinks alcohol takes a large dose of pure alcohol at a time.

If assistance is not provided in a timely manner, a critical condition , which will develop into death.

First aid for alcohol poisoning

First of all, if you suspect, let alone observe, signs of alcohol poisoning, even subtle symptoms with a fair amount of alcohol consumed, you should call an ambulance. To call an ambulance, you need to dial 03 from a landline phone or 112 from a mobile phone and be prepared to provide the address where the patient is located.

What else can be done when alcohol poisoning is obvious. If the patient is conscious, but there is lethargy, severe weakness, drowsiness on the face, ammonia vapor is allowed to inhale. To do this, a gauze or cotton swab soaked in ammonia is brought to the nasal opening; an accessible method of providing assistance in case of poisoning is to prepare a non-concentrated solution of soda (1 teaspoon per liter) in cold water and give it to drink, then gently press with a spoon on the root of the tongue , thereby causing vomiting.

If the poisoned person is able to swallow, the poisoned person should be given up to twenty tablets of activated carbon at a time. You can give an anti-hangover drink, for example, “Cheerfulness”, up to three sachets per mug, or drink hot, strong tea. But these measures are possible if the poisoned person can control his actions.

If a person who has consumed a lot of alcohol has lost consciousness, it is important, before the ambulance doctors arrive, to carefully monitor that his tongue is not stuck, that nothing restricts his breathing, except that the poisoned person cannot choke on his own vomit. If you lose consciousness from poisoning, it is contraindicated to rinse your stomach; the person may choke. Ethyl alcohol causes vasodilation, which means that the body affected by poisoning loses heat quickly. As a result, hypothermia may occur.

It is important to take warming measures: move the patient to a warm place or at least wrap him well. Place the poisoned person on his side, partially on his stomach so that his head is lowered, then possible vomit will not enter the respiratory tract. If cardiac activity stops and breathing stops, resuscitation measures are immediately started to maintain vital processes until doctors arrive.

Last year, on the territory of the Russian Federation, several large quantities of counterfeit well-known brands of alcoholic beverages were discovered, which were consumed via the Internet and resulted in several deaths due to the content of methyl alcohol.

Methyl or wood alcohol itself is less toxic than ethyl alcohol and differs little from it in properties, but in the process of its oxidation, extremely toxic products (formic acid and formaldehyde) are formed in the body, which cause delayed and very serious consequences. Individual sensitivity to methyl alcohol varies even more than to ethyl alcohol. The minimum lethal dose for humans is considered to be 100 ml. Death occurs from respiratory paralysis and weakened cardiovascular activity (in approximately 25% of patients with severe poisoning) against the background of severe decompensated metabolic acidosis.

With very large doses of methyl alcohol, poisoning can occur in the so-called fulminant form. Euphoria, coordination disorders and excitement are replaced by anesthesia and coma, combined with collapse. All phenomena develop faster than under the influence of ethyl alcohol, and death can occur within 2-3 hours. Treatment in such cases is carried out in the same way as for alcoholic coma.

But more often, mild and moderate intoxication passes much faster than intoxication after taking ethyl alcohol, and a latent period, or a period of visible well-being, begins. It lasts from several hours to several days, after which a delayed form of poisoning gradually develops. It is divided according to severity into three degrees: mild, moderate (ophthalmic) and severe (generalized). There is no direct connection between the duration of the latent period and the severity of the subsequent clinical picture and prognosis.

Symptoms

With a mild form of poisoning, headache, nausea, persistent vomiting, pain in the stomach, dizziness and necessarily moderate visual disturbances appear - “fog before the eyes”, “darkening in the eyes”. All these phenomena last from 2 to 7 days, then pass.

In the moderate or ophthalmic form of poisoning, the same phenomena are observed, but more pronounced, and after 1-2 days blindness occurs. Less commonly, blindness occurs immediately after poisoning; in this case, vision is first slowly restored, but not completely, and after some time it deteriorates again. Visual impairment is almost always asymmetrical. The prognosis for life is favorable, but for vision is poor. It is believed that with this form, vision is restored to its original state in no more than 10-12% of patients. An unfavorable prognostic sign is persistent pupil dilation.

The severe form begins in the same way, but then drowsiness and stupor quickly appear, often turning into a coma. With incomplete loss of consciousness, patients complain of blindness. Coma is characterized by cyanosis (blueness of the skin and lips), decreased blood pressure and sudden respiratory disturbances, usually of the Kussmaul type (rare single breathing movements). Cramps are often observed, generalized (general) or limited to the muscles of mastication (trismus) and the occipital muscles. There may be motor agitation. The pupil is sharply dilated, the reaction to light is absent or sluggish. When examined in a hospital, acetone bodies are found in the urine, a decrease in the alkaline reserve of the blood, methyl alcohol in all secretions, and during ophthalmoscopy - optic nerve atrophy, papillitis. Death may occur 1-2 days after the onset of the disease. The prognosis is bad.

This poisoning should be distinguished from poisoning with ethylene glycol, atropine and plants containing the latter (henbane, datura, belladonna, mandrake, panther fly agaric), and from botulism. Methyl alcohol poisoning is characterized by the presence of a long latent period, the alcoholic smell of all secretions - urine, vomit, gastric lavage, eye damage, and the absence of persistent changes in the urine. For all the poisonings mentioned, except for poisoning with ethylene glycol, the presence of a long latent period is uncharacteristic, and in case of poisoning with the latter poison there is no damage to the eyes and an alcoholic odor, but there are constant gross changes in kidney function (protein, crystals, calcium oxalate in uroliguria, increased residual blood nitrogen).

First aid for methyl alcohol poisoning.

Urgently call an ambulance or transport the victim to a medical facility (hospital).

Save the remains of the alcoholic drinks you take so that in the future you can clarify what exactly the victim was poisoned with.

Provide a flow of fresh air (open the window, take the victim outside).

If the victim is still conscious, it is necessary to immediately induce vomiting in order to lavage the stomach. Use cool soda solution as a solution. About 1 liter of this solution should be given to the victim to drink, and then vomiting should be induced by irritating the back wall of the pharynx and the root of the tongue. Repeat the procedure several times if the victim’s condition allows. This will help reduce intoxication and remove methyl alcohol remaining in the stomach.

Give the victim any laxative immediately.

Give the victim a soda solution to drink.

If necessary, warm the victim using heating pads and blankets.

If the symptoms of poisoning clearly indicate that methyl alcohol poisoning has occurred, the victim is given 40% ethyl alcohol (vodka) to drink in small doses (50-100 ml of vodka) every 3 hours. Ethyl alcohol replaces methyl alcohol and is actually an antidote.

Consequences of poisoning with alcohol surrogates

Despite the fact that the course of poisoning with alcohol substitutes containing ethyl alcohol is more favorable, the consequences can be very serious. The prognosis is determined by the amount of counterfeit alcohol consumed, and, to a greater extent, by the timeliness of the medical care provided. If the patient suffered from chronic alcoholism, the poisoning is more severe and there are more deaths than in those who did not have alcohol dependence.

When intoxicated with methanol, complete loss of vision is possible, which is not restored after the poison is removed from the body. Ethylene glycol-based surrogates lead to kidney failure. Such patients mostly die.

The problem of poisoning with alcohol surrogates, unfortunately, remains relevant today. Many people are faced with this disease, so knowing the signs of such intoxication will help not only provide timely emergency assistance to the victim, but also save his life!

Methods for determining methyl and ethyl alcohol

Recently, the quality of alcohol has begun to decline noticeably. Today it is dangerous to buy alcoholic drinks even in specialized stores. The reason for this is a large number of counterfeit products that reach the shelves without appropriate checks and proper control.

Counterfeits often contain methyl alcohol instead of ethyl alcohol, which is a real poison for the body. Drinking just 30 grams of such alcohol can cause serious damage that is irreversible, or even death. Therefore, you can only buy alcohol from reliable and trusted suppliers who guarantee the high quality of their products.

There are several ways to distinguish methyl alcohol from ethyl alcohol yourself at home. These include:

Setting fire. This is one of the simplest methods to maximally test an alcoholic drink for quality. To do this, about 10 grams of liquid is poured into a glass, then it is slightly shaken and set on fire. Ethyl alcohol has a blue flame, while methyl alcohol has a green flame.
Experiment with copper wire. In order to determine the type of alcohol, you need to prick the wire tightly and then dip it into a container with liquid. If methyl is poured, the person will immediately feel an extremely unpleasant odor reminiscent of formaldehyde. In the case of ethyl, the aroma may be completely absent or a subtle smell of apples will be heard.
Potato. The root vegetable is completely peeled and cut into small pieces. To conduct the experiment, one slice of vegetable thrown into a container with alcohol is enough. If methyl is poured, then after a few hours the potatoes will turn pink, but in ethyl the color of the vegetable will not change. Experience will not give reliable results when additional additives are present in the alcoholic drink. They can also cause the root crop to turn different shades.
Potassium permanganate. If even a small amount of potassium permanganate crystals gets into an alcohol-containing liquid, then in the case of methyl alcohol, smelly formaldehyde gases are released, and with ethyl, a slight aroma of vinegar may be felt or a complete absence of odor is observed.
Heat. This is one of the most controversial ways to correctly determine the type of alcohol. To carry out the experiment, you need to use the boiling method. For methyl alcohol, the first bubbles appear at a temperature of 65 degrees, for ethyl alcohol - at 80.

If you have doubts about the quality of an alcoholic drink, it is better to carry out several checks. It will take a little longer, but the results will be as accurate and truthful as possible, which can protect a person from poisoning .