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Acute alcohol intoxication characteristics in children.
Mailis Tõnisson1, Vallo Tillmann, Anne Kuudeberg
1Department of Pathological Anatomy and Forensic Medicine, University of Tartu, Biomedicum, Ravila 19, Tartu, Estonia. mailis.tonisson@ut.ee
Alcohol and Alcoholism (Oxford, Oxfordshire)
|May 2, 2013
Summary
Clinical assessment of acute alcohol intoxication (AAI) in children, using serum alcohol concentration (SAC) as a benchmark, is reliable. Consciousness is the key indicator, and a SAC to blood alcohol concentration (BAC) ratio of 1.19:1 is recommended for legal cases.
Area of Science:
- Pediatric Emergency Medicine
- Toxicology
- Clinical Diagnostics
Background:
- Acute alcohol intoxication (AAI) in children presents unique diagnostic challenges.
- Accurate assessment of AAI severity is crucial for appropriate medical intervention.
- Existing methods for determining AAI may differ in their correlation with clinical signs.
Purpose of the Study:
- To characterize clinical, mental, and physical signs in children with varying AAI severity.
- To evaluate the diagnostic performance of clinical assessments for AAI.
- To establish the serum alcohol concentration (SAC) to blood alcohol concentration (BAC) ratio in pediatric populations.
Main Methods:
- Analysis of data from 256 children (aged 8.4-17.9 years) hospitalized with AAI.
- Standardized forms detailing clinical, mental (consciousness, balance, speech), and physical signs.
- Measurement of both SAC and BAC, alongside calculation of diagnostic performance characteristics and the SAC:BAC ratio.
Main Results:
- Consciousness and speech were the most accurately described clinical signs correlating with SAC.
- Severity of altered consciousness, balance, and speech positively correlated with SAC.
- Clinical judgment of AAI severity aligned better with SAC than BAC; the mean SAC:BAC ratio was 1.19 ± 0.13.
Conclusions:
- Level of consciousness is the primary clinical sign for evaluating pediatric AAI, showing a strong correlation with SAC.
- Clinical assessment of AAI severity more closely matches SAC-determined severity than BAC-determined severity.
- A SAC:BAC ratio of 1.19:1 is recommended for legal contexts involving children, irrespective of age or gender.
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