14th ed. Rick Daniels, RN, PhD. WebMD:. Calculating BrAC The typical metric for BrAC is g/210L. For example, breath alcohol concentration (BrAC) readings obtained by breathalyzers or breath testers are converted to BAC. Falleti et al. Lipincott Williams and Wilkins: 2007. Food delays gastric emptying into the duodenum. The concentrations of ethanol determined in serum or plasma can be converted to the concentration in blood using known values of the serum/blood concentration ratios. WebSo, to convert a urine test result into an equivalent blood alcohol level, it's necessary to divide the urine alcohol level by 1.33. Fuel Cell Output vs. Time with Various Load Resistors. On this page, you can convert blood alcohol level values between different units viz., mg/mL, mg/L, g/dL, g/L, and mmol/L. Blood Alcohol Concentration Unit Conversion - BAC Some impairments of motor skills may take place in some individuals, and as a result, in some countries, e.g., Germany, the legal limit of driving is 0.05%. Nevertheless, in postmortem investigations, knowledge of the alcohol content of any one of these and other fluids can often be used to estimate the minimum blood alcohol concentration existing some time before death. Miscellaneous drugs, materials, medical devices, and techniques. It appears that the caloric value of the meal is more important than the precise balance of nutrients. The variability in the inter-person and intra-person blood-to-breath ratio could under or overestimate the true BAC as measured directly from the blood. Substantial research has established that the effect of alcohol on the human depends on the blood alcohol concentration. Eric B Staros, MD Associate Professor of Pathology, St Louis University School of Medicine; Director of Clinical Laboratories, Director of Cytopathology, Department of Pathology, St Louis University Hospital Slight impairment of balance, speech, vision, reaction time, and hearing, euphoria. Jones, in Encyclopedia of Forensic and Legal Medicine (Second Edition), 2016. When alcohol is present, this solution turns green. The peak blood ethanol concentration and the area under the curve are reduced if ethanol is consumed with food. Liver imaging is emerging as theradiagnostic tool to image liver tissue changes with localization of cellular or molecular lesions or infiltration. BAL (ethanol) Unit Conversion Page :: MediCalculator - ScyMed female drinking seven drinks in one hour, your BAL is a .30%. St. Louis, Mo: Elsevier; 2019. Toxic concentration is dependent on individual tolerance and usage although levels greater than 300-400 mg/dL can be fatal due to respiratory depression. The following conversion factors are recommended depending on whether results are intended for research, clinical, or legal purposes. However, it is adequate if the primary goal is to determine if alcohol has been consumed. among individuals according to age, gender, genetic makeup, and state of intoxication, within a given individual at different times. Multiply C Units -first Ethanol, a water-soluble 2 carbon chain molecule (CH2CH3OH), is absorbed primarily in the small intestine and secondarily in the stomach. Please read the Duke Wordpress Policies. Alcohol Alert,, No 72. [1], To convert serum ethanol level to BAC, move the decimal point 3 places to the left. Although this technique produces good linearity, the time to complete conversion of alcohol to electric current increases because of the load resistance of the measurement circuit. Use the Table of Blood Alcohol Levels below. Enzymatic colored strip reacts and changes depending on concentration of alcohol in saliva. Moreover, many industrialized countries such as Austria, France, Germany, and Italy have set legal limit of driving at 0.05%. Side effects of a higher BAC include slurred speech, slowed reflexes, loss of physical coordination, and troubled memory (U.S. National Library of Medicine, 2020) (Table 2). Generally, there are two different types of breath analyzer tests: preliminary alcohol screening (PAS) tests and evidential breath tests (EBTs). Serum or plasma can be stored frozen. This means that roughly 2,100 milliliters (ml) of breath will contain the same amount of alcohol as 1 ml of blood. In our state even if you are under the limit you can still be convicted of Driving under the influence of alcohol. The difference in blood alcohol levels in males and females has been attributed to differences in the distribution of body fat, with more fat per kilogram (thus less water) for females, and lower gastric levels of the alcohol-metabolizing enzyme alcohol dehydrogenase in females. WebOur calculator can give you an approximate BAC level, but do not rely upon it to determine if you're fit to drive or work. Alcohol intoxication initially impacts the frontal lobe region of the brain, causing disinhibition, impaired judgment, and cognitive and problem-solving difficulties. Table 2. I have looked all over the net trying to convert these readings and I am getting wildly differing results. A characteristic location for focal fatty change is the medial segment of the left lobe of the liver (segment IV) either anterior to the porta hepatis or adjacent to the falciform ligament. Therefore, analysis of alcohol in other body fluids is common in forensic laboratories. Available at: http://forcon.ca/learning/alcohol.html. Emotional swings and depression may be observed in some individuals. BrAC is able to provide a direct and accurate report of BAC due to the relationship between breath and blood. The alcohol concentration in a body tissue or fluid is generally proportional to the water content of that tissue or fluid. R. Sharma, in Bioactive Food as Dietary Interventions for Liver and Gastrointestinal Disease, 2013. 87114. Acetate finally breaks down into carbon dioxide and water. Collection method: Routine venipuncture, but site should be cleansed with a nonalcohol solution such as benzalkonium chloride or aqueous povidone-iodine. Toxic concentration is dependent on individual tolerance and usage although levels greater A.W. The blood test result of 191 mg/dL is equivalent to 0.191% (vs. legal limit of 0.08%. Urine alcohol levels peak 45-60 minutes after ingestion and are considered approximately 1.3-1.5 times greater than blood levels. Direct measurements have shown that the average distribution ratio for ethanol between serum (plasma) and whole blood is 1.15:1, with a range from 1.10:1 to 1.20:1 (Charlebois et al., 1996). People should arrange a designated driver or have an alternative plan to get home, such as a cab ride. At a blood alcohol level of 0.3% and higher, complete loss of consciousness may occur and a blood alcohol level of 0.5% and higher may even cause death (Table 1.2). In a study conducted by Mitchell and colleagues, the effect of different alcoholic beverages (5.1% beer, 12.5% wine and 20% vodka/tonic) on the rate of rate of absorption and BAC in a fasting state was evaluated. As you consume alcohol, it goes into your bloodstream. For example, if the water content of a body tissue is 10% higher than that of blood, the tissues alcohol content should be 10% higher than that of blood. If a person has a BAC of .10% that means that a persons bloodstream contains one part alcohol for every 1000 parts blood. (n.d.). Blood Alcohol Content (BAC): What It Is & Levels Food-induced impairment of gastric emptying may be partially offset by faster absorption of ethanol in the duodenum. Ultrasound features only become apparent when the amount of fat reaches 1520%. The area under the BEC/time curve (AUC) is reduced (Figure 4). In animal studies ethanol is often administered with other nutrients in liquid diets. Potentially fatal and a person may be comatose. From: Raj's Practical Management of Pain (Fourth Edition), 2008, Amitava Dasgupta, in Alcohol, Drugs, Genes and the Clinical Laboratory, 2017. WebHowever, a linear regression model was found to provide adequate prediction intervals at any desired level of confidence for whole blood alcohol from serum alcohol levels up to Referencing the Blood-Alcohol Chart below and SUBTRACTING the % of alcohol "burned up" during the time elapsed since your first drink, you will be able to estimate your Blood Alcohol Content (BAC). A breathalyzer typically refers to a handheld device that analyzes a persons breath to determine their blood alcohol concentration. If you log out, you will be required to enter your username and password the next time you visit. The ratio varies: WebAn Alco-Sensor IV law enforcement grade breathalyzer. This diagnosis is suggested when a person can function in a relatively normal capacity (without evidence of intoxication) with a blood ethanol level greater than 150 mg/dL. Blood Alcohol Level Chart and Easy Guide - Healthline This color change creates an electrical current, which the breathalyzer can convert into a value to determine the BAC. Physiological effects of blood alcohol levels as reported in NIAAA/PUBCHEM. Temporal variations in the UAC/BAC ratio were measured, and the mean ratio was less than unity for the 60 minute void, whereas at 120 minutes (the post-resorption phase) and all later times, the UAC/BAC ratio was 1.25 or more (a ratio equal to 3.6 after 8 hours). Urine ethanol samples are known to be imprecise in estimating BAC and the degree of intoxication. bottle of beer or 5 ozs. Severely intoxicated individuals may require admission to the hospital for management in specialized units with close monitoring and respiratory support. Between 400mg% and 799mg% blood alcohol level, the onset of alcohol coma can occur. PAS tests refer to the small handheld devices that police may use in the field to determine a persons BAC. 1 The effect of alcohol is primarily dependent on the blood alcohol concentration. What does it feel like to be drunk? However, although PAS tests and personal devices can be a useful indicator of a persons BAC, they are not always accurate. Alcohol consumption effects the brain resulting in difficulty walking, blurred vision, slurred speech, slowed reaction times, and impaired memory (Alcohols Damaging Effects on the Brain, 2021). MRI is choice of microimaging of soft tissues. Using the partition ratio, a breathalyzer can calculate a persons BAC. Generally, a breathalyzer is able to measure BAC due to a chemical reaction. The alcohol vapor in a persons breath reacts with an orange solution known as potassium dichromate. Fast Five Quiz: How Much Do You Know About Alcoholism? Alcohol evaporates in the lungs, and air from the lungs is then exhaled through the mouth. BAC. Memory of the drinking episode was evaluated to determine if there had been either a grayout (partial anterograde amnesia) or a blackout (complete anterograde amnesia). Comparative NMR Biochemical Correlation Analysis of Liver with Diffused Injury by Different Methods Using NMR Relaxation Times, In Vitro NMR Spectroscopy, In Vivo MR Spectroscopy, Tissue Metabolites, and Serum Enzyme Levels. DUI alcohol breathalyzer tests. Kathleen T. Brady, in The Effects of Drug Abuse on the Human Nervous System, 2014. Content: The Breathalyzer Assumes a Specific Blood-to-Breath-Ratio to Calculate the BAC, The Alcohol Pharmacology Education Partnership, Alcohol: The Biology, Chemistry, and Pharmacology, Workshop #2 Alcohol and the Breathalyzer Test, Part 1, Workshop #2 Alcohol and the Breathalyzer Test, Part 2, Module 4: Alcohol and the Breathalyzer Test, Module 3: Alcohol, Cell Suicide, and the Adolescent Brain, Content: How Does Ethanol Get to the Lungs, Content: Ethanol Vaporizes to a Gas in the Lungs, Content: Ethanol Leaves the Lungs in the Air, Content: Ethanol in the Blood Equilibrates with Ethanol in the Alveolar Air, Content: Redox Chemistry Inside the Breathalyzer. Gross motor impairment and lack of physical control. Re: Need to convert blood alcohol levels. As blood alcohol levels increase in humans, the impact of alcohol on cognitive abilities, psychomotor performance, and vital physiologic functions increases (Naranjo and Bremner, 1993, Table 2). Alcohol Blood Level - an overview | ScienceDirect Topics Learn more about the effects of alcohol, and how much might be too much, Although alcohol affects people in different ways and some people can drink more than others, drinking too much may cause a person to feel drunk, We look at the best ways to sober up fast. In general, a blood alcohol level of 20 mg/dL to 50 mg/dL represents mild intoxication, while levels of 300 mg/dL to 400 mg/dL can cause unconsciousness, Generally, the BAC limit in the U.S. is 0.08%. Available at: http://pubs.niaaa.nih.gov/publications/AA72/AA72.htm. (n.d.). Table 3. WebBAC 0.0%: Theres no alcohol in your blood (youre sober). Preeti Dalawari, MD, MSPH, FAAEM, FACEP is a member of the following medical societies: Academy for Women in Academic Emergency Medicine, American Academy of Emergency Medicine, American College of Emergency Physicians, Society for Academic Emergency MedicineDisclosure: Nothing to disclose. Physiological effects of various blood alcohol levels. WebBlood alcohol concentration (BAC) is a commonly used measure of alcohol intoxication, also known as drunkenness. Legal limit of driving in United States. The authors concluded that despite similar amount of ethanol in 12oz of beer, 5oz of wine and 1.5oz of liquor, the peak BAC may be higher in individuals drinking more concentrated beverages in the absence of food (Mitchell Jr et al., 2014). However, other factors can also influence a persons BAC, such as: If a person wishes to consume alcohol, it is advisable to do so in moderation. A subject ingested 0.8gkg1 ethanol over 30 minutes either after an overnight fast or after breakfast. McCurley, J. Dysphoria (anxiety, restlessness) predominates, nausea may appear. Clinical Manifestations of Blood Alcohol Concentration, Source: Reproduced with permission (Mayo-Smith, 2009). [12] Note that a positive alcohol level (especially in the altered mental status patient or possible psychiatric patient) does not preclude further workup because many organic disorders can mimic alcohol intoxication or be confounded by this diagnosis. Therefore, when the time between the alleged crime and the blood sampling is more than 8 hours or when the BAC is close to 0g/kg, it is recommended to collect one urine sample and to determine the urine alcohol (ethanol). Serum ethanol levels may be ordered in suspected alcohol ingestion as well altered mental status of unknown etiology, coma, psychiatric emergencies, traumatic emergencies, and history of other ingestions (eg, toxic alcohol, salicylates). ScienceDirect is a registered trademark of Elsevier B.V. ScienceDirect is a registered trademark of Elsevier B.V. Essentials of Pain Medicine and Regional Anesthesia (Second Edition), Alcohol, Drugs, Genes and the Clinical Laboratory, Alcohols Damaging Effects on the Brain, 2021, Encyclopedia of Forensic Sciences (Second Edition), The Effects of Alcohol on the Human Nervous System, The Effects of Drug Abuse on the Human Nervous System, Biochemical Mechanisms of Fatty Liver and Bioactive Foods, Bioactive Food as Dietary Interventions for Liver and Gastrointestinal Disease, http://radiopaedia.org/articles/focal_fat_infiltration. X = 300 Sample size, N = 850 Confidence level = 90%. No. However, it is more common for law enforcement to request a breathalyzer test if they suspect that a person has been drinking alcohol and not complying with a drinking-related law, such as driving under the influence of alcohol. Alcohol: Absorption, Metabolism, and Physiological Effects, Encyclopedia of Human Nutrition (Third Edition), Alcohol: Acute and Chronic Use and Postmortem Findings, Encyclopedia of Forensic and Legal Medicine (Second Edition), The threshold concentration for alcohol in urine is 107. STAT!Ref Online Electronic Medical Library. Most of those deceased were male [5]. This article will use the terms male, female, or both to refer to sex assigned at birth. McCurley, J. At a blood alcohol level of 0.3% and Alcohol: Absorption, Metabolism, and Physiological Effects, Encyclopedia of Human Nutrition (Third Edition), Alcohol: Acute and Chronic Use and Postmortem Findings, Encyclopedia of Forensic and Legal Medicine (Second Edition), The threshold concentration for alcohol in urine is 107. As blood passes through the lungs, some alcohol evaporates and moves into the lungs. Table 3. The effect of alcohol is primarily dependent on the blood alcohol concentration. Please note that serum or plasma concentration is approximately 1.2 times higher than whole blood. Phillips and Brewer commented that accident severity increases when the driver is merely buzzed compared to sober drivers because buzzed drivers are significantly more likely to speed, and the greater the blood alcohol, the greater the speed as well as the severity of the accident. According to the Dietary Guidelines for Americans 20202025, this means drinking no more than one standard drink per day for females and two per day for males. There were differences in (1) the mean total number of drinks ingested before the arrest; (2) gulping of drinks; and (3) blood alcohol concentration at the time of arrest for those who had blackouts compared with no amnesia; while there were differences in drinking more than planned between those without amnesia and those with grayouts. Alcohol blood levels have been measured after celiac plexus block using 50 mL of 50% ethyl alcohol. Blood Alcohol Drinking and driving is a dangerous combination. Drinking excessive alcohol in one occasion may cause alcohol poisoning which if not treated promptly may be fatal. blood alcohol level of 300 conversion to breathalyzer Drinkers who experience blackouts typically drink too much and too quickly, which causes their blood alcohol levels to rise very rapidly (Alcohols Damaging Effects on the Brain, 2021; Parsons, 1996; White, 2003). [8]. However, at blood alcohol levels that exceed the legal limit for driving in United States, significant impairment of motor skills may occur. Food-induced impairment of gastric emptying may be partially offset by faster absorption of ethanol in the duodenum. Blood alcohol content or blood alcohol concentration is a means to measure the amount of alcohol present in a persons bloodstream. Substantial research has established that the effect of alcohol on the human depends on the blood alcohol concentration. Comparative NMR Biochemical Correlation Analysis of Liver with Diffused Injury by Different Methods Using NMR Relaxation Times, In Vitro NMR Spectroscopy, In Vivo MR Spectroscopy, Tissue Metabolites, and Serum Enzyme Levels. There was a strong linear relation between blood alcohol concentration and the predicted probability of memory loss, particularly for blackouts. Blood alcohol concentrations are typically measured during intoxication, at the onset of withdrawal symptoms, and during the fully developed withdrawal syndrome. A questionnaire was administered regarding any recent alcohol-associated arrest with a documented blood alcohol concentration over 80mg/dl (14.3mmol/l) for public intoxication, driving under the influence, or under-age drinking. However, at blood alcohol levels that exceed the legal limit for driving in United States, significant impairment of motor skills may occur. This value is used to calculate the BAC from the Breathalyzer test. For example, other compounds in the breath, the temperature, a persons health, and human error may affect the accuracy of readings. [QxMD MEDLINE Link]. The degree of intoxication throughout the United States is measured by a blood alcohol level, and the legal limit is 0.08gram%. The ratio of breath alcohol to blood alcohol is roughly 2,100:1. Women tend to have a higher BAC compared to men of comparable weight after drinking same amount of alcohol Furthermore, food intake decreases rate of absorption and increases rate of ethanol elimination, leading to a decreased BAC. It is typically expressed as a percentage of alcohol per This assumption is based on Henrys Law which states that, at constant temperature, the concentration of gas dissolved in a liquid is proportional to its concentration in the air directly above the liquid. Wallach, Jacques. (Eds. Blood Alcohol Concentration - Rev. James E. McDonald, C.S.C., The different blood ethanol profile in these models may affect the expression of pathology. (Eds. This website also contains material copyrighted by 3rd parties. Heavy drinking can cause permanent impairment on the brain, whereas moderate drinking can cause short term impairment on the brain (Alcohols Damaging Effects on the Brain, 2021). In a breath test, one must calculate how much ethanol measured from the expired air sample is in the blood. While a breathalyzer gives fast results, it is not as accurate as measuring alcohol in the blood. Alcohol, also known as ethanol, is the main ingredient of alcoholic drinks such as beer, wine, and liquor. When you have an alcoholic drink, it is absorbed into your bloodstream and processed by the liver. The possible critical value for blood ethanol is >300 mg/dL. WebTo use the Breathalyzer, the subject exhales through the mouthpiece into a test chamber filled with a reddish-orange solution of potassium dichromate (K 2 Cr 2 O 7 ). 87114. Free calculators and unit converters for general and everyday use. Although blood alcohol concentrations are most commonly used to assess the degree of alcohol intoxication, blood is not always available for analysis, and it may be in poor condition, especially in postmortem investigations. demonstrated that cognitive impairment associated with 0.05% blood alcohol is similar to staying awake for 24h [7]. Dietary guidelines for Americans, 20202025. To reach a 0.157% a 165 pound man would need about 9 beers over 2 hour period. Presence of high amounts of alcohol, specifically BAC levels reaching 0.2500.399%, in the body severely impairs parts of the brain responsible for breathing, heart rate, and body temperature leading to loss of consciousness and alcohol poisoning (Alcohol Poisoning Deaths, 2021; University of Notre Dame, 2021). The National Transportation Safety Board in 2014 recommended lowering the legal limit of driving in the United States to 0.05%, but it is not adopted as the law. Centrifugation: Serum should be immediately separated from the red blood cells and analyzed within 4 hours when collected without preservatives. Source: Reproduced from Jones, A.W. However, food increases splanchnic blood flow, which maintains the ethanol diffusion gradient in the small intestine. WebBlood Alcohol Level (BAL) is the amount of alcohol present in your blood as you drink. This means that 1 milliliter of blood has 2100 times more ethanol than 1 milliliter of air from the lungs. After 360 minute post-drinking, as the BAC decreased below 0.5g/kg, the mean UAC/BAC increased significantly and continued to increase as the BAC approached zero. reported that postmortem blood alcohol levels ranged from 136 to 608mg/dL in 39 individuals who died due to alcohol overdose. Eric B Staros, MD is a member of the following medical societies: American Medical Association, American Society for Clinical Pathology, Association for Molecular Pathology, College of American PathologistsDisclosure: Nothing to disclose. This is why a court may require either an EBT result or a blood test to confirm a persons BAC. of table wine. Alcohol consumption effects the brain resulting in difficulty walking, blurred vision, slurred speech, slowed reaction times, and impaired memory (Alcohols Damaging Effects on the Brain, 2021). The association between blood alcohol concentration and the presence and degree of amnesia has been investigated in actively drinking subjects(1C). Thus, the bioavailability of alcohol was the least after drinking beer. Table 1.2. Moreover, clinical laboratories report ethanol concentrations in mmol/l, where 21.7mmol/l = 100mg/100ml or 0.1% w/v. Blood ethyl alcohol concentrations are measured using gas chromatography (Brown and Long, 1988) or determined in the plasma using the alcohol dehydrogenase method, which requires a spectrophotometer to measure the absorbance at 340 nm (Pointe Scientific, Canton, MI). Figure 41.4. An individual can use a personal device to measure their own BAC. Legal limits may vary, but generally, it is illegal for a person with a BAC of 0.08% or above to drive. Heavy drinking can cause permanent impairment on the brain, whereas moderate drinking can cause short term impairment on the brain (Alcohols Damaging Effects on the Brain, 2021). ClinLab Navigator:. Thus, urine samples should not be left at room temperature for prolonged periods of time. Ask Patients About Their Alcohol Consumption, Study Suggests, Early Intervention Can Keep Guns Out ofYouths' Hands, Alcohol Abuse: Complications and Consequences, Substance Abuse Disorders May Share a Common Genetic Signature. Blood samples are usually collected from the tail vein in mice or by intracardiac sampling in deeply anesthetized rats using large-bore (21-gauge) needles to prevent hemolysis. By continuing you agree to the use of cookies. 2011a. This is a generalized chart based on a person who is metabolizing (or breaking down) one drink an hour. Figure 2. The higher the BAC, the more significant impairments as described above. Legal limit of driving in United States. Preeti Dalawari, MD, MSPH, FAAEM, FACEP Associate Professor, Director of Research, Department of Surgery, Division of Emergency Medicine, St Louis University School of Medicine; Attending Physician in Emergency Medicine, St Louis University Hospital The presence of food not only reduces blood alcohol level but also stimulates its elimination through the liver. Metabolism is anywhere from 10-30 mg/dL/hour and depends upon a multitude of factors, including liver size. Available at: http://www.clinlabnavigator.com/Test-Interpretations/alcohol-ethanol-ethyl-alcohol.html. Breath alcohol measurement is reported to have been used in research since the 1970s [71]. A subject ingested 0.8gkg1 ethanol over 30 minutes either after an overnight fast or after breakfast. WebBlood alcohol concentration Breath alcohol concentration Blood/breath ratio of alcohol; Most European nations: 0.50 g/l0.25 mg/l2000:1: The Netherlands: 0.50 mg/ml220 Table 3 compares blood ethanol concentrations when expressed in different units as adopted for forensic purposes in various countries; the equivalent concentrations in mmol/l are also shown for comparison. London: The Pharmaceutical Press, pp. Thus, the bioavailability of alcohol was the least after drinking beer. For an adult, a BAC of 0.08% may correspond to consuming four or more drinks typically five or more drinks for a male in 2 hours. Unfortunately, different countries opted to use different BBRs to arrive at statutory BrAC limits ranging from 2000:1 to 2400:1as indicated by the information in Table 1. WebTo monitor your BAC levels, you can look up a blood alcohol content chart online or purchase a personal breathalyzer device. This is compared to a color scale. All material on this website is protected by copyright, Copyright 1994-2023 by WebMD LLC. Our online tools will provide quick answers to your calculation and conversion needs. Signs of severe alcohol intoxication and a person may not be able to move without the help of another person. Emotional swings and depression may be observed in some individuals. Many different factors can affect the accuracy of a breathalyzer test. Start Here Reset Fields Male Female Beer 12oz - 5% ABV Vomiting, incontinence, symptoms of alcohol intoxication. Additionally, the volume of air that a person exhales when performing the test can affect the accuracy of the results. Blood Alcohol Chart For Estimation - Breathalyzer - Alcohol Tester Retrieved from http://www.accessmedicine.com/content.aspx?aID=4509578. The BAC is affected by different factors such as gender, body weight, amount of alcohol consumed, how quickly the alcohol is consumed, and food intake (Dasgupta, 2017). Relaxed feeling, being social with others, Moderate to significant impairment of driving skills; changes in mood depression or excitement, Severe impairment of motor function, speech, and judgement; slurred speech, Needs assistance walking, loss of consciousness, Neurologic impairment with prolonged reaction time, ataxia, incoordination, and mental impairment, Very obvious intoxication, except in those with marked tolerance nausea, vomiting, marl-zed ataxia, Hypothermia, severe dysarthria, amnesia, Stage 1 anesthesia, Onset of alcoholic coma, with precise level depending on degree of tolerance, Often fatal because of loss of airway protective reflexes from airway obstruction by flaccid tongue, from pulmonary aspiration of gastric contents, or from respiratory arrest from profound central nervous system obstruction.
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