Take Home Points
- Chronic drinkers and even just acutely intoxicated patients are at risk of many medical emergencies including life threatening trauma, infections, metabolic derangements and tox exposures. Don’t dismiss them as “just drunk”
- Undress these patients and perform a thorough head to toe examination, focusing on looking for e/o trauma and infection. Get as much history as you can and be sure to ask about their drinking habits and etoh w/d hx to risk stratify them in your brain
- Always check FS glucose and replete glucose as needed.
- Consider giving your chronic intoxicated patients thiamine injections semi-regularly to prevent WE, and look for e/o the triad in your patients as it can be easily overlooked and deadly if missed!
EM Docs: EM@3AM Alcohol Intoxication
EM Updates: Emergency Management of the Agitated Patient
Life in the Fastlane: Ethanol Intoxication, Abuse and Dependence