Alcohol (acute intoxication and alcohol withdrawal syndrome).
Severe situational stress/anxiety.
ACUTE ALCOHOL INTOXICATION
a. Alcohol normally acts as a depressant. It dulls reflexes, dulls sense of
awareness, decreases reaction time, and depresses one's inhibitions (therefore,
sometimes thought of as stimulant).
The acutely alcohol intoxicated patient may exhibit signs like patients with
physical injuries or illnesses. Also, alcohol intoxication may mask signs and
symptoms of underlying physical or psychological illness.
b. Acute disorientation can occur with varying levels of alcohol intake in an
inexperienced drinker (young, elderly, and so forth). Normally, the average adult would have to
drink enough to become sedated before becoming disoriented. Disorientation often
occurs when alcohol is mixed with other drugs.
c. A drunken patient may show extreme behavior. He may exhibit aggression,
destructiveness, belligerence, combativeness, paranoia, and/or inappropriate behavior.
d. Gross behavioral disturbance is often a sign of an underlying or additional
problem besides ingestion of alcohol (for example, psychiatric illness, ingestion of
hallucinogenics or stimulants).
e. Alcohol withdrawal syndromes occur in a person who is used to constant
alcohol intake. When the supply is withdrawn, the patient may manifest alcohol
hallucinations and/or delirium tremens.
f. Management of acutely alcohol intoxicated patient.
Protect the patient from harming himself and/or others.
Maintain the patient's airway and prevent him from aspiration.
Monitor the patient's vital signs.
Evaluate the patient for underlying illness and/or injury.
Administer oxygen to the patient and start an IV with normal saline.
(6) Prepare to have the patient evacuated to the nearest medical treatment