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EMS News in Focus
by Arthur Hsieh

Alcohol-related calls: 7 reminders for this weekend

Keep the following tips in mind when you encounter a patient who went out of his/her way to overindulge this holiday

By Arthur Hsieh

Editor's note: Bay Area doctors and emergency workers are bracing for what's likely to be the busiest weekend of the year. Check out Art Hsieh's patient care reminders below.

We are heading into a fabulous weekend where New Year's celebrations will be held. No doubt more than a few of us EMS providers will also partake in the traditional celebration, perhaps with a glass or two of champagne or other alcoholic beverage.

But for those of us who will be serving our communities, Near Year's celebrations fuel a potentially greater-than-usual number of alcohol-related illnesses and injuries in our call volume.

When it gets especially busy, it becomes tempting to "triage" intoxicated patients and leave them in the care of well-meaning but unprepared family and friends.

Keep the following tips in mind when you encounter a patient who went out of his/her way to overindulge this holiday weekend:

1) While intoxication when driving legally occurs at 0.08g of ethanol per 100ml of blood, that's merely the definition. An individual may feel euphoric and engage in risky behavior much sooner than that.

2) Women do tend to become intoxicated sooner than men. For example, a 140 pound male can reach the 0.08 limit within three bottles of beer, glasses of wine or shots of hard liquor, while a 140 pound female can hit the same limit in just two drinks.

3) Alcohol takes about 45 minutes to hit its peak limit. In another words, the intoxicated individual weaving in front of you may become even more altered, even in the absence of more drinking.

4) Ethanol has emetic properties — i.e. it can trigger the vomiting effect without warning. Laterally positioning the patient will go a long way in keeping the airway patent.

5) Alcohol ingestion begins in the middle school population, sometimes by parents who condone drinking within their homes as a "safety" measure. The adolescent body is not as well prepared to handle alcohol poising, and can cause respiratory failure on its own.

6) Alcohol and drugs often go together. Remain vigilant for the use of stimulants that may mask the effect of alcohol, or depressants that can amplify intoxication.

7) Finally, there are several conditions that can mimic alcohol intoxication, such as diabetic ketoacidosis or an evolving brain injury. Do not be lulled into a snap judgment about alcohol being the culprit; perform a consistent, reasonable assessment for each patient, not matter how drunk they may appear to be.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P currently teaches at the Public Safety Training Center, Santa Rosa Junior College in the Emergency Care Program. Since 1982, Art has worked as a line medic and chief officer in the private, third service and fire-based EMS. He has directed both primary and EMS continuing education programs. Art is a textbook author, has presented at conferences nationwide, and continues to provide patient care at an EMS service in Northern California. Contact Art at Art.Hsieh@ems1.com.
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