Ethanol intoxication in children: Clinical features, evaluation, and management
- Carl R Baum, MD, FAAP, FACMT
Carl R Baum, MD, FAAP, FACMT
- Associate Professor of Pediatrics
- Yale University School of Medicine
- Section Editor
- Michele M Burns, MD, MPH
Michele M Burns, MD, MPH
- Section Editor — Pediatric Toxicology
- Assistant Professor of Pediatrics and Emergency Medicine
- Harvard Medical School
- Deputy Editor
- James F Wiley, II, MD, MPH
James F Wiley, II, MD, MPH
- Senior Deputy Editor — Adult and Pediatric Emergency Medicine
- Senior Deputy Editor — Primary Care Sports Medicine (Adolescents and Adults)
- Clinical Professor of Pediatrics and Emergency Medicine/Traumatology
- University of Connecticut School of Medicine
The evaluation and management of ethanol intoxication in children is discussed here.
Epidemiology, pharmacokinetics, estimation of toxicity, and toxic effects seen in pediatric ethanol exposure are discussed separately. (See "Ethanol intoxication in children: Epidemiology, estimation of toxicity, and toxic effects".)
A rapid overview provides an approach to ethanol intoxication in children (table 1).
History — It is important to rapidly determine if the "alcohol" ingestion is ethanol or one of the toxic alcohols (eg, methanol, ethylene glycol). (See "Methanol and ethylene glycol poisoning".)
Infants or young children who have ingested enough ethanol to cause a peak serum level ≥50 mg/dL (11 mmol/L) are at risk for profound hypoglycemia and require emergent evaluation. (See "Ethanol intoxication in children: Epidemiology, estimation of toxicity, and toxic effects", section on 'Estimation of serum ethanol'.)
- Dine MS, McGovern ME. Intentional poisoning of children--an overlooked category of child abuse: report of seven cases and review of the literature. Pediatrics 1982; 70:32.
- Ricci LR, Hoffman SA. Ethanol-induced hypoglycemic coma in a child. Ann Emerg Med 1982; 11:202.
- Nawrot M, Nordenstrom B, Olson A. Disruption of eye movements by ethanol intoxication affects perception of depth from motion parallax. Psychol Sci 2004; 15:858.
- Barnhill MT Jr, Herbert D, Wells DJ Jr. Comparison of hospital laboratory serum alcohol levels obtained by an enzymatic method with whole blood levels forensically determined by gas chromatography. J Anal Toxicol 2007; 31:23.
- Hlastala MP. The alcohol breath test--a review. J Appl Physiol (1985) 1998; 84:401.
- Morgan DL, Durso MH, Rich BK, Kurt TL. Severe ethanol intoxication in an adolescent. Am J Emerg Med 1995; 13:416.
- Osterhoudt KC, Burns Ewald M, Shannon M, Henretig FM. Toxicologic emergencies. In: Textbook of Pediatric Emergency Medicine, 6th ed, Fleisher GR, Ludwig S, Henretig FM (Eds), Lippincott Williams & Wilkins, Philadelphia 2006. p.965.
- Vogel C, Caraccio T, Mofenson H, Hart S. Alcohol intoxication in young children. J Toxicol Clin Toxicol 1995; 33:25.
- Selbst SM, DeMaio JG, Boenning D. Mouthwash poisoning. Report of a fatal case. Clin Pediatr (Phila) 1985; 24:162.
- CLINICAL FEATURES
- Physical examination
- DIFFERENTIAL DIAGNOSIS
- Blood glucose
- Ethanol level
- Other studies
- Supportive care
- Gastrointestinal decontamination
- Extracorporeal removal
- Child protection
- - Symptomatic patients
- - Asymptomatic patients
- - Suicidal overdose
- ADDITIONAL RESOURCES
- SUMMARY AND RECOMMENDATIONS
- Clinical features