The immediate concern when someone has passed out from drinking is recognizing a life-threatening medical emergency, not simply waking them up. Alcohol is a central nervous system depressant, and excessive consumption can lead to fatal alcohol poisoning. The first action is to call 911 or your local emergency services immediately if the person is unresponsive or exhibiting severe symptoms. Securing professional help is the only way to ensure the person’s safety.
Prioritizing Safety: Recognizing Alcohol Poisoning
Determining the difference between deep sleep and alcohol poisoning is difficult, yet the distinction is a matter of survival. Alcohol poisoning is an overdose where toxic alcohol concentration shuts down involuntary functions like breathing and the gag reflex. This state is dangerous because the blood alcohol concentration (BAC) can continue to rise even after drinking stops, as alcohol remaining in the stomach enters the bloodstream.
A person suffering from alcohol poisoning may exhibit profound confusion or stupor, making them difficult or impossible to rouse fully. Breathing may become dangerously slow (fewer than eight breaths per minute) or irregular, with gaps of more than ten seconds. The depressant effects of alcohol also reduce body temperature, leading to hypothermia, often evidenced by cold, clammy, or pale skin.
The loss of the protective gag reflex is one of the most serious complications, as it increases the risk of aspiration. If the person vomits while unresponsive, they can choke on their stomach contents, leading to asphyxiation or severe aspiration pneumonia. Other severe signs necessitating an immediate emergency call include seizures, blue-tinged skin (cyanosis), or incontinence. If there is any doubt about the person’s state of consciousness or breathing, calling emergency services is the only appropriate response.
Immediate Care for the Unconscious Person
While waiting for emergency personnel, the primary goal is to maintain an open airway and prevent aspiration. Do not leave the person alone, as their condition can deteriorate rapidly. Your presence allows for continuous monitoring of their breathing and responsiveness until medical help takes over.
If the person is unconscious but breathing, place them into the recovery position to prevent the tongue from blocking the airway and allow fluids to drain. Kneel beside the person and ensure both legs are straight. Take the arm nearest to you and place it out at a right angle to their body, with the elbow bent and the palm facing upward.
Next, bring the arm farthest from you across their chest and hold the back of that hand against the cheek closest to you. With your other hand, bend the leg farthest from you up at the knee, ensuring the foot remains flat on the floor. Use the bent knee and the arm supporting the head to gently roll the person towards you, onto their side.
Once on their side, adjust the top leg so the hip and knee are bent at right angles; this stabilizes the body. Gently tilt the head back to keep the airway open, ensuring the hand under the cheek acts as a cushion. Continually check for breathing by placing your ear near their mouth and nose to “Look, Listen, and Feel” for air movement and chest rise for no more than ten seconds.
Dangerous Interventions to Avoid
Attempts to force consciousness or speed up the sobering process are ineffective and can increase the risk of injury or death. The body metabolizes alcohol at a set rate, typically about one standard drink per hour, and no external intervention can accelerate this process. Forcing the person to walk or engaging in aggressive shaking can cause them to fall and sustain a head or neck injury, which is dangerous in an already compromised state.
Giving the person coffee or energy drinks is not helpful, as caffeine is a stimulant that does not counteract central nervous system depression. It can mask the severity of the intoxication and increase dehydration, which alcohol exacerbates. Furthermore, attempting to give any liquid to an unresponsive person increases the risk of aspiration due to the depressed gag reflex.
Putting an unresponsive person into a cold shower or bath is a harmful misconception. Alcohol causes blood vessels to dilate, leading to rapid heat loss and increasing the risk of hypothermia. Sudden exposure to cold water can induce hypothermic shock, potentially leading to cardiac arrest, and the individual could also drown if they lose consciousness.
Post-Incident Monitoring and Follow-Up
Once emergency services have intervened, continued observation remains necessary, particularly as the person regains consciousness. Even after medical clearance, the individual may still be recovering from severe dehydration and low blood sugar (hypoglycemia). If they are awake and able to swallow, offer small, frequent sips of water or an electrolyte solution to aid rehydration.
Encourage rest and do not permit them to drink any more alcohol, as their system is still processing the toxins. Monitor for lingering symptoms such as persistent vomiting, severe headache, or confusion that does not resolve. If the individual suffered a fall or head trauma, or experiences memory loss that does not improve after several hours, a follow-up medical evaluation is appropriate.
Continued observation is important because the full effects of alcohol poisoning can take time to manifest, and the body requires time to restore its chemical balance. If any initial signs of alcohol poisoning return or worsen, or if the person remains drowsy and difficult to wake, seek further medical attention immediately. The goal of post-incident care is to support the body’s natural recovery process while ensuring no secondary complications arise.