When encountering a person who has consumed too much alcohol, the primary objective is ensuring their safety, as acute intoxication can quickly become a life-threatening medical emergency. Understanding the practical steps to take, and the actions to avoid, is the best way to provide appropriate care. This knowledge allows bystanders to make informed decisions that protect the health and well-being of the intoxicated person.
Recognizing Signs of Alcohol Poisoning
The first step is to assess the individual for signs of alcohol poisoning, which requires immediate professional medical intervention. Alcohol acts as a depressant on the central nervous system, and a severe overdose can halt basic bodily functions like breathing and heart rate. If you observe any indication of a medical emergency, call 911 or your local emergency services immediately.
A useful way to remember the signs of alcohol poisoning is by using the acronym C.U.P.S.
C: Cold, Clammy, or Pale Skin
Alcohol affects the brain’s ability to regulate body temperature, often leading to hypothermia and a bluish tint, particularly visible on the lips or under the fingernails.
U: Unresponsive
This means the person cannot be roused by shouting, shaking, or pinching. If they pass out and cannot be woken up, they are in serious danger.
P: Puking
This refers to vomiting, specifically when the person is passed out or semi-conscious. Since alcohol inhibits the gag reflex, an unconscious person is at a high risk of aspirating, or choking on, their own vomit.
S: Slow or Irregular Breathing
This indicates that the central nervous system is dangerously suppressed. A breathing rate of fewer than eight breaths per minute, or lapses of more than ten seconds between breaths, warrants an emergency call.
A person does not need to exhibit all of these symptoms to be in danger; the presence of even one sign is sufficient cause to seek emergency help. Alcohol concentration can continue to rise even after the person stops drinking, sometimes for up to 90 minutes, meaning their condition can rapidly worsen. If there is any doubt about the severity of intoxication, the safest course of action is to call for medical assistance.
Providing Immediate and Ongoing Care
For an intoxicated person who is conscious and not exhibiting signs of alcohol poisoning, or while waiting for emergency services, immediate care focuses on monitoring and protection. The most important protective action is placing the person in the recovery position if they cannot sit up. This technique involves gently rolling the person onto their side with their top leg bent at the knee and their head tilted back to keep the airway open and allow fluids to drain from the mouth.
The recovery position safeguards against aspiration, a common cause of death in alcohol-related emergencies. Never leave an intoxicated person alone, as their level of consciousness can suddenly decrease. Continuously monitor their breathing and responsiveness, checking frequently to ensure they can still be roused.
Maintaining a stable body temperature is also necessary, as alcohol consumption causes blood vessels to dilate, leading to rapid heat loss. Keep the person warm with a blanket or coat, even if the environment does not feel cold. If the individual is conscious and can swallow safely, offering small sips of water can help address the dehydration caused by alcohol.
If the person becomes emotional, aggressive, or argumentative, remain calm and use simple, direct language. Avoid engaging in arguments or making threats, as their judgment is severely impaired, and confrontation can escalate the situation. Keep them quiet and comfortable, speaking with a calm, firm voice to guide them. The goal is to provide a safe, non-judgemental environment while waiting for the effects of the alcohol to diminish.
Dangerous Actions to Avoid
Several common but dangerous interventions should be avoided when helping someone who is drunk. Do not attempt to give the person coffee or any caffeinated beverage to “sober them up.” Caffeine is a stimulant that can worsen alcohol-induced dehydration and does nothing to reduce the alcohol concentration in the bloodstream. Only the liver can metabolize alcohol at a steady rate, typically 0.016% of Blood Alcohol Concentration (BAC) per hour.
Putting an intoxicated person into a cold shower or attempting to make them walk around is ill-advised and potentially harmful. A cold shower can cause the person to go into shock and may increase the risk of hypothermia, since alcohol lowers body temperature. Forcing them to exercise or walk will not hasten the sobering process and could lead to injurious falls.
Never attempt to induce vomiting, as this significantly increases the risk of aspiration, especially if the person has a diminished gag reflex. Similarly, do not leave the person alone to “sleep it off” in a position other than the recovery position. As long as alcohol is still being absorbed into the bloodstream, their BAC can continue to rise, and a person who is sleeping could slip into an unresponsive state, making monitoring impossible.