17 years old male with altered sensorium and vomiting after binge of alcohol.
17 years old male with altered sensorium and vomiting after binge of alcohol.
August 8, 2023
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Unit posting (Intern 2017)
Medical Ward
GM II
Dr Nikitha
Dr Haripriya
Dr Govardhini
Dr rahul
17 years old male with altered sensorium and vomiting after alcohol intake.
17 years old male patient(school going student)was brought to casualty in unconscious state with a history of alcohol intake.
HISTORY OF PRESENTING ILLNESS
Patient was apparently asymptomatic till 6:30pm and then he developed altered sensorium and 2 episodes of vomiting(containing food )
The scenario was-
Patient was at home since morning.
➡️Around 11 am,
he took his meal containing rice, vegetable curry (the only meal he had yesterday according to his parents)
➡️Around 4:30 pm,
he went with his friends to celebrate his friend's birthday.They went to a park.
According to his friends he drank 5 bottles of beers in that birthday party.
➡️Around 6 pm,
he called his parents and asked them to switch on the geyser as he wanted to take bath after reaching home.
➡️Around 6:30 pm,
he developed altered sensorium and had one episode of vomiting(non foul smelling,content as food particles) in the park.
➡️Around 7:30 pm,
his friends brought him to his home.After reaching home, he had another episode of vomiting (non foul smelling,content as food particles)
His parents were scared and brought him to hospital.
According to his parents, this was the first time he consumed alcohol.
At presentation-
GCS SCORE-E1V1M4
PR 96 bpm
RR 18cpm
BP 60/40 mmhg
SPO2 99%
GRBS 119mg/dl
GENERAL EXAMINATION
Well informed consent is taken. Examined in a well lit room.
Patient is Unconscious.Oriented to person.
Thin built and moderately Nourished.
Vitals
Afebrile
BP 60/40mmhg
PR 96bpm
Respiratory rate 18 cpm
There is no pallor,icterus, clubbing, cyanosis or lympathadenopathy,Pedal Edema
SYSTEMIC EXAMINATION
Abdominal examination
Soft, non tender.
Bowel sounds heard.
Cardiovascular system examination
S1 and S2 heard , no added thrills and murmurs heard.
Respiratory system examination
BAE +
Normal vesicular breath sounds heard
No adventitious sounds
CNS EXAMINATION
GCS SCORE - E1V1M4
INVESTIGATION
PROVISIONAL DIAGNOSIS
Altered sensorium secondary to alcohol intoxication
TREATMENT
8/8/23
1.At presentation,BP was 60/40 mmg after giving 500ml of NS bolus, BP was 90/60mm hg
2.INJ.THIAMINE 800 mg in 500 ml NS IV STAT
9/98/23
TAB. THIAMINE 100 mg PO/BD
Psychiatry opinion was taken on 9/8/23, patient is counselled and psychotherapy is done.
Harmful effects of alcohol has explaned
