The most important aspect of the management is recognition that the patient has been exposed to a toxic alcohol. The ABC's should be managed first and as the patient is stabilized further thought can be given to the general management of the patient. Unless the amount of ethanol or other alcohol is large and very recent there is very little indication for gastric lavage as the alcohols are well absorbed from the gut. Charcoal does not absorb the alcohols well, so unless there is another suspected toxin, there is little need for charcoal. Further specifics will be discussed below.
Ethanol is a colorless, odorless hydrocarbon that is both water and lipid-soluble.
It diffuses easily across all membranes which explains its ability to affect multiple organ systems. The lipid solubility accounts for the rapid absorption of ethanol from the GI tract. This absorption is affected by the presence of food in the gut, GI motility or disease, coingestion of drugs, concentration of the alcohol, and the time over which the alcohol is consumed. Women achieve higher blood alcohol levels than do men for equivalent doses of alcohol. Alcohol is broken down in the liver by alcohol dehydrogenase.