What alcohol level do you admit for?

Specialties Emergency

Published

Nothing drives me more crazy than the drunks. We have people that bring in their friends who are fine, but have an alcohol level of 200, so we admit them overnight for IV fluids. What level does your ER keep patients from, assuming everything else about the patient is fine?

Jessica

Specializes in ER.

We mostly admit by the patients behavior not there BAC-- but I am dreading when school starts up again because we have a private college with a bunch of rich snotty kids that got there and there friends always call 911 or bring them to the ER when they have drank to much-- and our hospital for PR purposes seems ta admit qiut a few of them because the college police department wants them to be admitted in case there friends wont keep an eye on them!! Nothing like a drunk, crying, sorority girl who has puked in her hair!!! At least I can send them upstairs and get them out of the ER!!!:banghead:

Specializes in Emergency Dept, ICU.

At this new hosital I work at, a bac over 300 will get you an admission. :(

But all the normal hospitals I've worked at in the past, you stay in the ER a bit until someone can take you home regardless of you ETOH level.

I guess I should have clarified, we admit patients for a BAC of 200 even though they have a sober friend who is capable of watching them and the pt has no problem protecting their airway, they are alive and well, despite the slurring.

Most of yhou are making me jealous seeing that you send them home. I hate wasting a bed on a drunk.

Jessica

We dont admit our drunk pts. We put them on one of the hallway beds and draw labs then let em sleep. Some docs will let their BACs drop down to 100 then they can go...but that might take 12 hours! Mind you these ppl are alcoholics, and a bac of 100 is sober to them.

Their stay with us depends on their behavior. If their screamin and yellin about going AMA and swearin at us about food and deficating in their pants/peeing in the hallways..AND theres a sober driver....then its time for them to go!

We have quite a few regulars who come via ems and wake up in the ER very angry ...swearing wheres my beer and cigarettes. I have yet heard one of them say I want help.

Specializes in Hospitalist.

Admit for 200?????!!!!!!! We would have a full house year round. 200 in my ER is a total lightweight. We hold them until the BAC is under 300 if they have a sober friend or they get a ride to the Hoosegow for the night. Under 80 they can walk. Honestly, the *only* patient I have ever admitted for alcohol intoxication had a BAC (I swear on my great-grandma's motorcyle) of 596. He drank 2 bottles of Haitian rum inside 10 minutes in a suicide attempt. He was tubed and vented. I had another one that was 576 walking and talking. We had to hold him for almost 12 hrs to sober him up to the point where he could get a ride with the po-po to the jail. I completely agree with not letting them get too low. Over 300 walking and talking is a serious alcoholic and they will start to DT within 2-6 hours depending on how hardcore they are. You wait too long and they will seize. I call the cops when I have about an hour left before they're below 300 so I can get them off to the jail before they do the funky chicken on me.

Specializes in ER, telemetry.

The ER I work at also does not admit for ETOH intoxication unless they have other medical or psych issues warranting an admission. We generally check ISTAT lytes, give a banana bag, and hold them until they sober up some. Then, we send them on their merry way with a responsible person or in a taxi.

We admit only if we have to intubate the patient for more then 5 hours no other time. We have some frequent flier who always come in with alcohol levels of 500 and are still talking. When they get to 200 we give them serax because they start having withdrawals. We had one woman who also had levels of at least 450. Most of the time we don't even draw blood, we just watch them all night then send them home at 0600. On many occassions we have had to intubate college kids at levels under 200. If they vomit and can't protect there own airway we intubate them if after 5 hours they are not awake and we can't extubate them then we admit. The kids we are talking are Harvard and MIT students. Believe me if anything happened to them, our carreer would be over.

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