When it comes to drunkenness, some people think of the pleasure brought by alcohol, and some people think of the headache of hangovers.
For forensics, drunkenness often corresponds to various accidents.
One day, the police station under the jurisdiction reported a police situation. In a company dormitory, a 23-year-old man was found dead in bed.
We immediately arrived at the scene. It was a three-bedroom, one-room residence where the deceased lived with two colleagues. The room was filled with a sour smell, and the deceased was lying on his back on his bed, well-dressed, with a small amount of vomit on his pillow and on the floor.
Two colleagues and roommates of the deceased reported that at the company dinner last night, the deceased drank 1 kilogram of liquor, plus 3 bottles of beer, and then began to sit unsteadily, and finally collapsed to the ground and passed out.
The two colleagues took him back to their dormitories, laid him flat on the bed, and then went back to their rooms to rest. Unexpectedly, the next day, he died in his bed.
Image source: Stand Cool Helo
The scene was simple, and no one else came in or out of the scene except two colleagues. No wounds were seen on the deceased's body and no medical treatment was found. A subsequent autopsy found that the concentration of alcohol in the blood of the deceased reached 4.68 mg/ml.
It is generally believed that when blood alcohol concentrations reach 4-5 mg/ml or more, they may be fatal [1]. Excessive alcohol intake easily penetrates through the blood-brain barrier and enters the brain, inhibiting the motor center and respiratory center, and in severe cases, respiratory and circulatory failure will occur and die [2].
However, although the blood alcohol concentration of the deceased is in the lethal range, whether he died of excessive blood alcohol concentration needs to be further tested.
In identification practice, there have been cases of death at a blood alcohol concentration of only 2.5 mg/ml, and there have been reports of survival as high as 6 mg/ml [1].
Next, we found that the deceased's eye conjunctiva had bleeding spots, and the lips and nails were purple, which were signs of suffocation. Indicates that the deceased may have died of asphyxiation.
So, is it respiratory failure caused by excessive blood alcohol concentrations?
Immediately after that, we examined the respiratory tract of the deceased and found that there was obvious food and mucus in his respiratory tract (bronchi and bronchioles), presumably inhaling vomit. Subsequent examinations found that there were no serious lesions or injuries to other organs of the deceased's body.
Combining these details, we finally determined that the cause of death was inhalation asphyxia after drinking, that is, the deceased accidentally inhaled his own vomit and caused suffocation, and then died.
The above case of death from inhalation asphyxia after drinking is actually very common in life.
After getting drunk, it is easy to vomit.
●On the one hand, after drunkenness, the pharyngeal muscles relax and the swallowing reflex weakens or disappears. At this time, if it is a supine position, when drunk and vomiting, the vomit is easy to regurgitate directly in the throat and slide into the trachea, resulting in the trachea being blocked and suffocated.
●On the other hand, if a drunk person sleeps on his back, vomit can easily be sucked into the respiratory tract by the nose, causing the airway to become blocked and choking to occur [3].
At this time, the drunkard himself is in a comatose state, unconscious or unresponsive, often leading to tragedy.
In order to avoid the recurrence of tragedy, both drinkers and caregivers have the consciousness of "lying on their sides after getting drunk", prevent vomit from being inhaled, and keep the airway open [4].
If you find that the drunk person has experienced aspiration and suffocation, you should dial 120 at the first time.
While waiting for the arrival of emergency personnel, first remove vomit or food debris from the mouth and nose of the drunk, and do not try to pat the back to shoot the obstruction, because this may make the obstruction deep into the respiratory tract, which is counterproductive.
If a drunken person is found to have a cardiac arrest, he should be given first aid using chest compressions to restore his cardiopulmonary function.
Methods of chest compressions:
● Hands crossed and overlapped, palms down, one hand on top, one hand on bottom, arms straight, vertically pressing the bone between the two breasts.
● By virtue of its own gravity, it is transmitted vertically to the sternum through both arms and palms, and transmits pressure to the heart and blood vessels, promoting blood flow.
●The compression frequency is guaranteed to be between 100 and 120 times per minute, and the compression depth should be between 5 and 6 cm [5].
After getting drunk, the body's perception and reaction ability will decline, which is a very dangerous state, and various accidents often occur.
The easiest and most straightforward way to prevent accidents is not to drink alcohol.
Review expert: Zhang Yuanchun | Chief Instructor of the American Heart Association Cardiovascular First Aid Training Program
bibliography
LIU Liang. Forensic Toxicology[M].4 ed. Beijing:People's Medical Publishing House,2009.]
Chen Haozhu,Lin Guowei,Wang Jiyao. Practical Internal Medicine[M].People's Medical Publishing House:Beijing,2016:820.]
Huang Xiaohong,You Meizhu. First aid experience of aspiration caused by acute alcoholism[J].China Health Nutrition (Mid-10Thirect),2014,24(4):2517.
Liu Shiping,Cao Xiaoping,Qiu Li,Feng Fei. Application of endotracheal intubation in rescuing patients with vomiting and asphyxia in acute alcoholism[J].China Practical Medicine,2016,11(15):265-265,266.
[5] Tencent Medical Code: Cardiopulmonary Resuscitation
*The content of this article is a popularization of health knowledge and cannot be used as a specific diagnosis and treatment recommendation, nor is it a substitute for face-to-face consultation by a practicing physician, for reference only.
*The copyright of this article belongs to Tencent Medical Code, unauthorized media reprinting is prohibited, and illegal reprinting will be investigated for legal responsibility according to law. Individuals are welcome to forward to the circle of friends.
* Welcome to WeChat search and pay attention to the public account "Tencent Medical Code" to get more health science knowledge.