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Alcohol & Respiratory Depression: BAC Thresholds & Emergency Response

Mechanism

Alcohol (GABAₐ agonist, NMDA antagonist) depresses pontine/medullary respiratory centers → ↓ respiratory drive, ↓ response to hypercapnia/hypoxia.

BAC–Effect Correlation

  • 0.02–0.05%: Mild sedation
  • 0.08%: Legal driving limit (US) — impaired coordination
  • 0.15–0.25%: Ataxia, slurred speech, nausea
  • 0.25–0.35%: Stupor, marked respiratory depression
  • ≥0.30–0.40%: Life-threatening respiratory depression, coma
  • >0.40%: Fatal (respiratory arrest, aspiration, hypothermia)

Critical Variables

  • Tolerance (chronic drinkers: right-shifted curve)
  • Age, weight, sex, medications (benzodiazepines, opioids → synergy)
  • Rate of consumption

Emergency Response

  1. Call 911 / EMS immediately
  2. Recovery position (if unconscious, breathing)
  3. Monitor airway, breathing, circulation
  4. Do not give food, water, coffee, cold shower
  5. Naloxone if opioid co-ingestion suspected

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