Methods for determining the state of intoxication

CASE STUDY: Methods for determining the state of intoxication

1. Description of the Clinical Situation

A 34-year-old man was brought to the admission department of a narcological dispensary by police officers. The patient had been stopped while driving a car. Police officers suspected that he was in a state of alcohol intoxication.

During examination the following signs were noted:

• smell of alcohol from the mouth
• facial flushing
• unsteady gait
• slowed speech
• impaired coordination of movements

The patient states that he drank “a small amount of alcohol” several hours earlier.

2. Task for Students

To determine whether the patient is in a state of alcohol intoxication, using clinical and laboratory diagnostic methods.

3. Stages of Patient Examination

1. Clinical Examination

• assessment of appearance
• state of consciousness
• coordination of movements
• gait
• speech
• behavior
• presence of alcohol odor

2. Psychoneurological Tests

• Romberg test
• finger-to-nose test
• coordination tests

3. Instrumental Methods

• breathalyzer (determination of alcohol in exhaled air)
• gas analyzer

4. Laboratory Methods

• determination of blood alcohol concentration
• determination of alcohol in urine

4. Examination Results (Example)

• Breathalyzer: 0.85 ‰ alcohol in exhaled air
• Blood test: 0.9 ‰ alcohol
• Impaired coordination and instability in the Romberg position

5. Questions for Discussion

1. What clinical signs indicate alcohol intoxication?
2. Which methods are the most objective for confirming intoxication?
3. How is a medical examination for intoxication performed?
4. What blood alcohol levels correspond to mild, moderate, and severe intoxication?

6. Conclusion

Based on clinical signs and laboratory test results, the patient was diagnosed with a moderate degree of alcohol intoxication.