AN EVALUATION OF INTRAVENOUS ETHANOL IN HOSPITALIZED-PATIENTS

Alcohol withdrawal is a serious complication of heavy alcohol use and a condition requiring patient stabilization before initiating surgery or implementing lifesaving procedures for injury. Intravenous ethanol (NE) is used to prevent withdrawal during these maneuvers. This report explores the use and potential problems of this practice in an academ ic urban medical center. This study was undertaken to improve the trea tment of NE recipients in an urban, academic health system providing t rauma surgery, and general inpatient services. All 68 patients, identi fied by a review of the pharmacy database for the period August 1993 t hrough January 1994, received IVE during their stay. A priori outcome measures related to the course of therapy in the selected cases. Of al l patients studied, 67.6% were admitted for alcohol-related trauma; 61 .8% of IVE recipients had no documented risk factors for delirium trem ens (59.5% of these were oriented); 17.6% were discharged on the same day the drip was discontinued; only 17.6% were referred to the alcohol consult team; and, throughout the course of therapy in all cases, pro blood alcohol level (BAL) determinations were recorded in patients' r ecords. The use of NE is associated with potentially serious clinical concerns. We found a high prevalence of alcohol-related admissions, in consistent NE administration, and a low rate of alcohol consult reques ts. Guidelines to improve the selection, management, and disposition o f NE recipients are suggested. (C) 1998 Elsevier Science Inc.