The primary concern when caring for a highly intoxicated person is ensuring their safety, as alcohol severely compromises the body’s ability to protect itself. Alcohol is a central nervous system depressant that slows down involuntary actions, including protective reflexes. The goal is to manage the effects of intoxication until the body can metabolize the alcohol, a process that cannot be accelerated. Proper care focuses on mitigating the risk of medical emergency and physical harm during this vulnerable period.
Assessing the Situation and Recognizing Danger
Before allowing an intoxicated person to sleep, determine if their condition is a medical emergency requiring immediate professional help. Alcohol poisoning is a serious, sometimes fatal, consequence of consuming too much alcohol too quickly, demanding a call to emergency services like 911. A primary sign of danger is an inability to be roused; if the individual cannot be woken up, they may be losing consciousness.
Look closely for dangerously slowed or irregular breathing, defined as fewer than eight breaths per minute or a gap of more than ten seconds between breaths. The skin may appear pale, clammy, or bluish, especially around the lips and fingernails, indicating hypothermia or poor circulation. Other severe symptoms include seizures, vomiting while unconscious, or the inability to control the bladder or bowels. If any of these signs are present, the situation requires emergency medical intervention, and you must stay with the person until help arrives.
Essential Care Steps Before Sleep
If the person is conscious and responsive, take certain steps before they attempt to sleep to prevent complications. Alcohol is a diuretic, causing the body to lose fluids, so encouraging slow sips of water helps replenish lost fluid. Avoid giving them coffee or energy drinks, as caffeine is also a diuretic that can worsen dehydration and offers a false sense of sobriety.
Avoid food if the person is heavily impaired, as chewing and swallowing can pose a choking hazard due to impaired motor skills. Alcohol depresses the gag reflex, significantly reducing the protective mechanism against vomit or food entering the lungs. If they feel nauseous, keep a bin or bucket nearby or ensure easy access to a toilet. Try to keep them sitting upright while they are actively vomiting. The focus remains on comfort and safety, as only time allows the liver to metabolize the alcohol.
Safe Positioning and Environment
The most important step for an intoxicated person ready to rest is placing them in the recovery position to safeguard their airway. This positioning prevents aspiration, which is the inhalation of vomit into the lungs, a potentially fatal complication due to the suppressed gag reflex. Roll the person onto their side, ensuring their head is supported and tilted slightly backward to keep the airway open and allow fluids to drain.
The upper leg should be bent at the knee and hip to a right angle to provide stability and prevent rolling onto their back. Their bottom arm should be extended for balance, and the top hand placed palm-down under their cheek to help maintain the head tilt. Creating a safe physical environment is also necessary. This involves removing sharp objects or hazards and ensuring the temperature is stable, as alcohol impairs the body’s ability to regulate temperature.
Monitoring and Follow-Up
Vigilance does not end once the person is safely positioned because the blood alcohol concentration (BAC) continues to rise even after the last drink. Alcohol remaining in the stomach and small intestine continues to be absorbed into the bloodstream, sometimes for hours after drinking stops. This means a person who appeared merely drunk can progress to life-threatening alcohol poisoning while they sleep.
Continuous monitoring is necessary; check on the individual every 15 to 30 minutes, especially during the first few hours of sleep. When checking, look at the rate and regularity of their breathing, the color of their skin, and their responsiveness to external stimuli, such as a gentle shake or a loud voice. If any danger signs, like difficulty breathing or inability to wake up, reappear or worsen, seek emergency medical help immediately.