title: Acute alcohol intoxication characteristics in children.
abstract: OBJECTIVE
  To describe clinical, mental and physical signs in children with different severity acute alcohol intoxication (AAI) determined either by serum alcohol concentration (SAC) or by blood alcohol concentration (BAC) to study the diagnostic performance characteristics of clinical assessment and to establish the ratio of SAC:BAC in children.
  
  
  METHODS
  Data were analysed from 256 children aged 8.4-17.9 years who were hospitalized at Estonia's two children's hospitals over a 3-year period. In each case, the on-call paediatrician completed a special form about the clinical, mental (consciousness, balance and speech) and physical (muscle tone, blood pressure, pulse and body temperature) signs of AAI. Blood samples were drawn for measurements of SAC and BAC. Diagnostic performance characteristics (sensitivity, specificity, efficiency) of the clinical assessments and the SAC:BAC ratio were calculated.
  
  
  RESULTS
  The most correctly described signs in children in different SAC groups were consciousness (rs = 0.16) and speech (rs = 0.13) (P < 0.0001). The severity of alteration of consciousness and degrees of disturbance in balance and speech were positively correlated with SAC (P < 0.001). The clinical judgment matched better with AAI determined by SAC rather than by BAC with the mean efficiency. The mean ratio between SAC and BAC was 1.19 ± 0.13 (P < 0.001) in children.
  
  
  CONCLUSIONS
  The level of consciousness is the leading sign in the clinical evaluation of children with AAI and correlates well with SAC. The severity of AAI judged by clinical assessment matched better with AAI severity stages determined by SAC than by BAC. For legal cases where BAC is required, the SAC:BAC ratio of 1.19:1 should be used in children regardless of their gender or age.
authors: Department of Pathological Anatomy and Forensic Medicine, University of Tartu, Biomedicum, Ravila 19, Tartu, Estonia. mailis.tonisson@ut.ee
authors: Mailis
authors: M
authors: Tõnisson
authors: Vallo
authors: V
authors: Tillmann
authors: Anne
authors: A
authors: Kuudeberg
authors: Delia
authors: D
authors: Lepik
authors: Marika
authors: M
authors: Väli
mesh_terms: D000293:Adolescent; D000435:Alcoholic Intoxication / Q000097:blood / Q000175:diagnosis*; D002648:Child; D003243:Consciousness / Q000187:drug effects; D000431:Ethanol / Q000097:blood / Q000378:metabolism* / Q000494:pharmacology*; D005260:Female; D006801:Humans; D008297:Male; D004856:Postural Balance / Q000187:drug effects; D012680:Sensitivity and Specificity; D044967:Serum / Q000378:metabolism; D012720:Severity of Illness Index; D013060:Speech / Q000187:drug effects
chemical_list: D000431:Ethanol