RECOGNITION AND TREATMENT OF ETHANOL ABUSE IN TRAUMA PATIENTS

OBJECTIVE: To evaluate physicians' recognition of possible ethanol-rel ated complications in trauma patients, and to compare benzodiazepine r equirements in patients with positive and negative blood-ethanol conce ntrations. DESIGN: Retrospective investigation. SETTING: University me dical center (level I trauma center). PATIENTS: One hundred thirty-one trauma patients more than 18 years of age who were admitted for at le ast 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 amo unt of benzodiazepines administered to trauma patients with positive E tOH-blood concentrations compared to trauma patients with no detectabl e EtOH in their blood. RESULTS: The presence of EtOH in the blood or t he potential for EtOH withdrawal was mentioned in the progress notes o f approximately one fourth of the patients with positive blood-EtOH co ncentrations. Thiamine was administered in 8.2% of patients with EtOH- related injuries. Benzodiazepine requirements were significantly highe r in patients with positive versus negative blood-EtOH concentrations. CONCLUSIONS: Prompt recognition and charting of suspected ethanol abu se is recommended, in conjunction with prompt administration of thiami ne. 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.