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Alcohol Poisoning, Emergency Medicine

Timothy J. Meehan Reviewed 06/2017
 


Basics

Description

  • Alcohol is the most commonly abused recreational agent among emergency department patients

  • Alcohol is frequently associated with traumatic injuries

Etiology

  • Alcohol intoxication:

    • Directl...

Diagnosis

Signs and Symptoms

Acute Alcohol Intoxication

  • CNS effects occur on a spectrum:

    • Relaxation

    • Euphoria

    • Sedation

    • Memory loss

    • Impaired judgment

    • Ataxia

    • Slurred speech

    • Obtundation/coma

  • May also cause GI upset

Alcohol Withdrawal Syndrome

Treatment

Pre-Hospital

  • Administer benzodiazepines for seizures

  • Give naloxone, oxygen, and dextrose for comatose individuals

  • Intubate as necessary for airway protection to prevent aspiration

  • C-spine immobi...

Follow-Up

Disposition

Admission Criteria

  • Inability to control seizures or withdrawal symptoms with oral medications

  • Hepatic failure, infection, dehydration, malnutrition, cardiovascular collapse, cardiac...

Pearls and Pitfalls

  • Failure to appreciate AMS due to nonalcoholic causes in chronic alcoholics:

    • Serum levels should drop by 15–40 mg/dL/hr

    • If mental status not improving (or worsening) need to investiga...

Additional Reading

  • D’Onofrio  G, Degutis  LC. Preventive care in the emergency department: Screening and brief intervention for alcohol problems in the emergency department: A systematic review. Acad ...

Codes

ICD9

  • 303.00 Acute alcoholic intoxication in alcoholism, unspecified

  • 305.00 Alcohol abuse, unspecified

  • 980.0 Toxic effect of ethyl alcohol

ICD10

  • T51.0X1A Toxic effect of ethanol, accidental (unintenti...

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