Does anyone know of any regulations which prohibit medication to someone with a Promille of 2,55?

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Sorry if this has already been discussed somewhere. The situation was such that the said person had eye muscle impairment (eyes asymmetrical and one drooping eye lid), ataxia, could hardly walk (had to be taken in a wheelchair), was anxious, sweating profusely, talking out loud to self, auditory illusions and most likely more. He had not had a drink for 10-12 hours. The alcohol withdrawal clinic in charge of his recovery used his BAL of 2,55 Promille as the excuse for not giving him any kind of medication. They also failed to start an IV, give him water or anything else. He did not survive. Thanks for any pointers to health regulations. I have been unable to find anything in the latest literature from WHO or elsewhere. 

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13 Replies

  • Posted

    Sorry to hear this person didn't survive, that is horrible.

    I think you need to contact the authorities in whichever country this happened in.  I doubt there is anyone here who would be able to answer your question with any certainty.

    Sorry to not be able to help!

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  • Posted

    Very little detailed information from you and impossible to give a satisfactory reply. a friend of yours? Family?Obviously a sad situation 😢

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    • Posted

      Which dertails would you need? Since the clinic never gave him any kind of medical examination or asked any questions at all....I have to base it on what I knew and observed as well as another patient's observations. Such a bad clinic-the staff had no idea of his condition.

      The public prosecutor states as a fact that no medication is administered with am BAL of 2,55 - which is of course nonsense since it all depends so much on the whole picture, medical history, level of withdrawl ´symptoms etc etc. 

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    • Posted

      Not that it would change my reply much since none of us here are likely to have any experience or training in regulatory procedures, you could start by at least informing us which country this happened in.

      With you saying 'public prosecutor' I am guessing the US somewhere?

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    • Posted

      Dembrandt,

      I have just looked over a couple of previous posts you have made and I see you mentioned Euros at some point, so it looks like you are somewhere in Europe.

      This forum is primarily used by those in the UK and America. 

      I'm afraid it is highly unlikely that someone here will know the regulations for any other European country.  To be honest, it's highly unlikely that any of us would know the regulations within our own countries.

      I'm sorry, but I just don't think you will get the answers you are looking for here on this forum and would be much better directed towards contacting the regulatory body in your country that oversees medical practices. 

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    • Posted

      Yes I have been trying to do that - there is a publication of 400 pages released in 2015 in which they basically allign themselves to the WHO's guidlines for Alcoholdisorder - regarding treatment, inital examinations and diagnosis during detox and withdrawal - which is why I asked. It does not stipulate any such rule, but emphasizes that all depends on the state the patient is in as well as their medical history and examination results, which sounds reasonable. I am in Germany. 

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  • Posted

    Agree with above replies, think you would be best to go through official complaints channel for the clinic/health board. There may be a support service that can guide you through this (for patients/relatives/carers). Sorry to hear this happened, it sounds awful. 
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    • Posted

      Just to clarify - I thiink I may have phrased this incorrectly: I meant to ask if anyone knows if giving medication to a person with an intoxication level of 2,55 would be harmful? It is not prohibited - but I also cannot find any information advising against it, rather the contrary - that medication is more likely to prevent a dangerous withdrawal. There is no indication of the BAL having to be below 2,55. Sorry for my error. It is all very awful.
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    • Posted

      Ok i see. It seems you are perhaps using a different way to measure blood alcohol levels though? In the UK it tends to be measured like this:

      “The maximum prescribed legal drink driving limit in England and Wales is 80mg/100ml blood or 0.08%”

      And from what i have read, when blood levels get to around 0.2% it’s getting life threatening. How does the German ‘Promille’ measurement compare? 

      Your next point of whether medications are indicated- it is such a specialist question. I understand why you have asked on here, in case anyone knows. I think you would be best to look into any published research/journal articles if you have any access to databases? If WHO don’t have any guidelines then perhaps it is just a local policy from that area not to give medication when the level is 2,55. Also, not every medical decision will be derived from a formal protocol, it could be the doctor or clinic’s discretion. In the UK we have NICE guidelines - you could look that up and see if any relate to this situation? They are all evidence based. 

      Hope that helps, sorry again for what you have been through.

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  • Posted

    I’m presuming you’re from Germany? I’ve no knowledge of this way of calculating the amount of alcohol in the blood. However 2,55 seems very high.l

    Im sorry I can’t help you.

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    • Posted

      Hi, actually no I am not German just living here. The problem was not so much the Al level (which is very high) but the abrupt cessation of alcohol, lack of medical support and rapid onset of withdrawal symptoms. I have found the guidlines - there is no such rule about withholding medication, in fact it is advised to provide pharma support immediately in order to avoid the development of withdrawal symptoms and thus preclude a dangerous situation. There are many factors involved but the hospital, police and public prosecutor are just bent on concealing important evidence and bending known events to cover their negligence and in end effect instrumenting of manslaughter. So nothing much changed here in the medical and judicial institutions since the 1930's. They all still collude to cover their crimes.

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