TheHot Tub Mystery
Alcoholalters brain stem depression and this results in a consequentdecrease in the general output of many organs and systems that workunder the brain’s coordination. For instance, the hypothalamus isaffected by alcohol. It depresses the central nervous system byinhibiting the activation of angiotensin two. There are vasodilationand respiratory system arrests that come about as a result of alcoholintake. In addition, the peripheral nervous system, which includesthe brain and the spinal cord, are tempered with after the intake ofalcohol. The pituitary gland located at the base of the brain, whichis the major control center of many other glands such as adrenalgland that produces antidiuretic hormone, is also affected byalcohol. The action of adrenal glands is depressed and stimulates thekidneys to reabsorb water instead of releasing water due to increasedblood pressure (Caro, 1978).
Reabsorbedwater by the kidneys is more harmful in this case since the waterincreases fluid within the blood leading to increased blood pressurewhich worsens the situation. There occurs an increase in the serumosmolality to about 280 as a result of hypernatremia. As a result,hypovolemic occurs that also constitutes an increase in bloodpressure. Low sodium ions lead to the inability of the brain todepolarize and repolarize and cause seizures and coma which are fatalconditions. Hypervolemia would also affect the sodium-potassium pumpthus lead to the loss of electrolytes.
Finally,alcohol levels in the blood of individuals can be expressed asblood-alcohol concentration (BAC). Level 4 levels of .15-25 wouldresult in several outcomes such as the inability to stand and walk,vomiting, slow breathing and confusion. These signs and symptomsexplain the death of these people.
Lasixis a medication prescribed to patients who suffer from bloodpressure. This medicine is used to lower blood volume throughincreased fluid loss by the urinary system which results to areduction in blood pressure. Reduction of fluid build-up in highblood pressure patients is directly influential by the decrease inthe blood pressure. Alcohol is antagonistic to the Antidiureticenzyme (ADH) action, and it blocks the enzyme’s action byfacilitating vasodilation. Increased water temperatures will alsocause the blood vessels to dilate so as to lose the much-gained heatand in turn, the blood pressure reduces. It is clear that the abovefactors do not favor fluid retention in the body, and it is achievedthrough exocytosis process to keep blood volume and pressure normal.Temperatures of 114 °C results in vasodilation, increased heart rateand lower blood pressure resulting in the compensatory mechanism tomaintain cardiac output (Caro, 1978).
Lossof ADH action due to alcohol effect and an addition of Lasix bothworsen the state of the patient as they lead to increased alkalosis.The pH goes higher than 7.4 as opposed to acidosis where it reduces.There is reduced hydrogen levels since most of the fluid loss isinhibited as the ADH and adrenal glands are suppressed. Alkalosisleads to several symptoms such as confusion with dysrhythmias,seizures, dizziness, anxiety and muscle cramps. This condition iscompensated through a ventilation mechanism called compensatoryhypo-ventilation. The aim of this mechanism is to maintain morecarbon dioxide that is used to lower the pH after it dissolves toform carbonic acid. Another way to counter alkalosis is throughreactive hyperemia which also aims at low perfusion that leads toincreased carbon dioxide levels in the blood to lower the pH.
Thebody has to fight to ensure normal functioning goes on and therefore,if not compromised by the mentioned life threating factors, it wouldcompensate the lower blood volume by triggering the adrenal gland toretain the fluid through the kidneys. These fluids would lower theblood pressure and counter the alkalosis conditions that had risen inthe deceased. Little fluid resulted in an imbalance in the calciumion–electrolyte ratio within the blood which led to the increase inthe pressure. The increase in the calcium levels responds to the highviscosity of blood (Caro, 1978). The increase in calcium levelsreferred to as hypo calcium triggers blood to bind to it to thepresent cations and this results to increased blood density whichconsequently reduces the standard blood viscosity. The viscous bloodis not able to meet the required heart rate from the cardiac pump andthus it results to confusions, convulsions and blood clotting withinvessels.
Alkalosisarose from the increased ions that bound to the blood, and most ofthe blood was pumped abnormally. This resulted in the accumulation ofvolumes of more blood within the vessels. More blood pressure is aresult of low stroke volume and thus, alkalosis results in anincrease in vasodilation and lower cardiac output. The bodycompensates this condition through the kidney by releasing the excessfluid bound in the blood to lower pressure through urine fluidexcretion (Caro, 1978).
Viscousblood flows slowly and it is not able to meet the nourishment of bodyorgans such as the brain and muscles. Petite oxygen and ions such aspotassium ions reached the muscles. This affects both the cardiac andsmooth muscles activities. For instance, the heart pumps the bloodslowly, the respiratory system becomes depressed and little oxygen ispumped while the toxic carbon dioxide was less removed from thetissues resulting to fatal concentrations. The heart rate is reduceddue to hypokalemia resulting to low cardiac output.
Carbondioxide accumulates to toxic levels since it is less excreted by thelungs. The toxic gas dissolves in the fluid of the blood to formcarbonic acid which alters the blood pH from a normal of about 7.4 to4.5 (acid). When the pH is lower, the acidosis is higher. Metabolicacidosis results in increased vessel dilation to enhance removal ofcarbon dioxide from the skin surface. Failure of this gas to leavethe blood means there lacks enough oxygen-carrying capacity withinthe red blood cells, and therefore, little oxygen reaches the brain.This resulted in mental alteration and an increased heart rate. Therate was faster but blood could not flow smoothly and it startedforming clots due to hypo-calcium levels and low cardiac output.
Thecentral nervous system (CNS) is the control center of all thephysiological processes of the body. Alcohol intake depresses thecentral nervous system which then results in depression of othersystems that are under its control such as the skeletal system andthe endocrine system. Poor valve coordination is as a result offailed central nervous system and it may cause peripheral resistanceto the flowing blood that may result in the hypovolemic shock orstroke volume that might be fatal to the couple.
Ifone is found unconscious, the paramedics could have opted to infusethe person with a fluid to boost their pressure. In addition, it isadvisable to provide oxygen to them and put them in a cooler placebefore taking them to the hospital.
Caro, C. G. (1978). The Mechanics of the Circulation. Oxford: Oxford University Press.