When a person is severely intoxicated, immediate safety precautions are necessary. Alcohol depresses the central nervous system, making the situation potentially life-threatening. Safe positioning and continuous oversight manage the risks associated with heavy intoxication until the body metabolizes the alcohol. Implementing practical steps can prevent serious complications.
The Primary Danger: Understanding Aspiration Risk
The greatest immediate danger for an intoxicated person who is sleeping or unconscious is pulmonary aspiration—the inhalation of foreign materials into the lungs. Alcohol is a central nervous system depressant that significantly impairs protective reflexes, including the gag and cough reflexes. When the gag reflex is suppressed, the body cannot prevent vomit or other stomach contents from entering the windpipe.
Intoxication often leads to nausea and vomiting. An unconscious person lying on their back may choke on their own vomit, which can lead to aspiration pneumonia or fatal airway obstruction. Correct positioning is essential to mitigate this risk.
Safe Sleeping Position and Environment
The most effective way to protect the airway of an intoxicated person who cannot be roused is to place them in the recovery position, also known as the lateral recumbent position. This position uses gravity to keep the tongue from blocking the airway and allows fluids, such as vomit, to drain safely from the mouth.
To execute the recovery position, kneel beside the person and ensure both legs are straight. Stretch the arm closest to you out at a right angle to their body, with the palm facing upward. Bring their other arm across their chest and place the back of that hand against the cheek closest to you, holding it for support.
Next, bend the leg farthest from you at the knee so the foot is flat on the floor. While supporting the head and neck, gently roll the person toward you by pulling on the bent knee. Adjust the bent leg so the hip and knee are at right angles, ensuring the body is stable and cannot roll onto its stomach or back. Finally, tilt the head back slightly to ensure the airway is open and clear. The person should be on a firm surface, and any heavy blankets or pillows that could obstruct breathing should be removed.
Ongoing Monitoring and Follow-Up Care
After safely positioning the person, continuous monitoring is necessary, as the blood alcohol concentration can continue to rise even after drinking stops. The person should never be left alone until they are fully conscious and responsive. Checks should be performed frequently, ideally every 30 to 60 minutes, to assess responsiveness and breathing regularity.
To check responsiveness, attempt to rouse the person by speaking their name or gently shaking their shoulder. If they wake easily and respond coherently, they are less likely to be in immediate danger. Monitor breathing closely; slow breathing (fewer than eight breaths per minute) or irregular breathing with pauses longer than 10 seconds are serious warning signs. Check their skin temperature; alcohol interferes with temperature regulation, so keep them warm with a light blanket to prevent hypothermia. If the person is conscious enough, encouraging sips of water helps with dehydration. Avoid giving them food, coffee, or medication, as these do not aid sobriety and can be harmful.
Recognizing Signs of Alcohol Poisoning
Alcohol poisoning is a medical emergency that requires immediate professional help. If any of the following signs are present, call emergency services immediately and do not attempt to “sleep it off.”
Signs of Alcohol Poisoning
- Inability to be roused or remaining unconscious even with stimulation.
- Seizures.
- Slow or irregular breathing (fewer than eight breaths per minute or pauses lasting more than 10 seconds).
- Skin that is pale, bluish, or cold and clammy, or a low body temperature.
- Repeated or uncontrollable vomiting while unconscious.