Lifesaving Liquor


Every ER employee has 234,973 tales of how alcohol ruined lives, which is true, it does.  But, once in a great while, alcohol is the answer.

Don’t get me wrong, whenever some absolute idiot gets behind the wheel after drinking it infuriates me.

I’m looking at you, Bieber!

Bieber

But that is not the story here.  Here is where alcohol saved the day.  On a personal note, I loves me a delicious Vandermill’s Cider now and again (click).  But,You see, I’m the type of guy who sees the vomit bucket of life as half full.

So our silly story starts seriously with some super-savvy alliteration.  Then, after a dramatic pause,

<pause>

and begin.

In residency I received a priority one call over the phone.

The ambulance was over an hour away.  The patient had consumed antifreeze (ethylene glycol) and was doing poorly.

For those of you who don’t know, antifreeze does have a somewhat sweet odor to it and technically is an alcohol, so it will get you drunk.  Unfortunately, it will also kill you.  According to Uptodate, 1 g/kg of ethylene glycol is considered lethal.  That’s not much (any amount more than a sip = go to the ER).

Our hero decided to drink a lot of antifreeze.  Then, after reconsidering his choice, he called EMS.  This is where I received the call.  So, what happened?

They were over an hour away, so this meant by the time he arrived at the hospital he might be dead.  The ethylene glycol itself is not too harmful, but it is broken down into glycolic acid.  This is the toxic substance that (along with oxalic acid) destroys a persons kidneys and then they die.

So where does the lifesaving liquor come into play?

Well, let’s go back to the fun filled happy world of chemistry!  YAY!

But chemistry is boring I hear you whining…

Not if my all time favorite wrestler Randy the Macho-Man Randy Savage explains it! (Click his pick below for a reminder of his awesomeness (seriously, this guy rocked))

Randy the Macho Man

Ooooooh Yeah!

You want to know?  Oh yeah, it’s going to go down like this.

We’ll call antifreeze “Hulk Hogan.”  Now when Hogan (Ethylene Glycol) binds like a sissy to the enzyme Alcohol Dehydrogenase, it turns to acid inside your veins.  It gunks up your kidneys like I gunked up Hogan in Wrestlemania V!

Ethylene Glycol Hogan1

So, how do you stop that sissy Ethylene Glycol from binding?  The cream rises to the top baby.  To the TOP!  You just add in something that binds extra-super tight to the Alcohol dehydrogenase.  So add some of the sweet Macho Man alcohol!  It binds a hundred times stronger to the alcohol-dehydrogenase enzyme so that no spots are open for that sissy Hogan.  Since Hogan can’t bind to the enzyme, it doesn’t get converted to the bad stuff, oh yeeeah!

Ethylene Glycol hogan2

Macho Man suplexes the enzyme 100 times stronger than Hogan, there’s just no room for him in the ring, back to you Rob.

Thanks Randy, may you rest in peace.

 

So what did I do?

Well, the ambulance had over an hour to drive, so I told them to pull over to the closest liquor store, buy a fifth of vodka and to have him take several shots.

True story.

In fact, some hospitals (that lack the newest, much more expensive antidote) still use alcohol drips.  Now THAT is one way to get blitzed.

Our patient ended up getting very sick, but he made it to the hospital and did fine (after his dialysis and ICU stay (and bicarb (and fomepizole).

 

Thus, the day was once again saved, thanks to alcohol, as Homer Simpson would say:

“To alcohol, the cause of, and solution to, all of life’s problems.”

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