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Recognition and treatment of ethanol abuse in trauma patients
B L Erstad1, D G Grier, M E Scott
1Department of Pharmacy Practice, College of Pharmacy, University of Arizona, Tucson 85721, USA.
Objective:
To evaluate physicians' recognition of possible ethanol-related complications in trauma patients, and to compare benzodiazepine requirements in patients with positive and negative blood-ethanol concentrations.
Design:
Retrospective investigation.
Setting:
University medical center (level I trauma center).
Patients:
One hundred thirty-one trauma patients more than 18 years of age who were admitted for at least 24 hours.
Outcome Measures:
(1) Physicians' recognition of ethanol (EtOH) as a potential factor complicating patient recovery in trauma patients admitted with positive blood-EtOH concentrations. (2) The amount of benzodiazepines administered to trauma patients with positive EtOH-blood concentrations compared to trauma patients with no detectable EtOH in their blood.
Results:
The presence of EtOH in the blood or the potential for EtOH withdrawal was mentioned in the progress notes of approximately one fourth of the patients with positive blood-EtOH concentrations. Thiamine was administered in 8.2% of patients with EtOH-related injuries. Benzodiazepine requirements were significantly higher in patients with positive versus negative blood-EtOH concentrations.
Conclusions:
Prompt recognition and charting of suspected ethanol abuse is recommended, in conjunction with prompt administration of thiamine. It should be anticipated that patients with positive blood-ethanol concentrations will require higher doses of benzodiazepines compared to trauma patients without ethanol-related injuries.