TITLE

Relationship Between Blood Alcohol Concentration and Observable Symptoms of Intoxication in Patients Presenting to an Emergency Department

AUTHOR(S)
Olson, Kalen N.; Smith, Stephen W.; Kioss, Julie S.; Ho, Jeffrey D.; Apple, Fred S.
PUB. DATE
July 2013
SOURCE
Alcohol & Alcoholism;Jul/Aug2013, Vol. 48 Issue 4, p386
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Aims: Clinical and medico-legal decisions often requite knowledge of alcohol impairnienl that is not necessarily revealed by an individual's appearance, and in turn, may not necessarily refitet level of blood alcohol. This study computes clinical signs and symptoms with measured and estimated blood alcohol concentrations (BACs). Method: Individuals (n = 384) perceived to be under the influence of alcohol at presentation 10 an emergency department were assessed by physicians and nurses for clinical features of alcohol intoxication (alcohol symptom checklist, ASC), who were asked to estimate the patienl's BAC. Relation to measured BACs was assessed by correlation. Results: BACs ranged from 0 to 418 mg/lOb ml. The correlation between the estimated BAC and measured BAC was r = 0.513. Measured BAC correlated with ASC r = 0.250. In subjects without a history of chronic drinking (n = 134) there was a better (P <0.05) correlation with the ASC score (r = 0.363) versus measured BAC compared with that for chronic drinkers (r = 0.154). The positive predictive value of estimating BAC at or above a particular BAC cut-off decreased from 93.2% at 100 mg/I 00 ml to 37.7% at 300 mg/100 ml (P<0.05). Conclusions: Measured BAC does not correlate well with the outward physical signs of intoxication, especially for chronic drinkers. There is a need for further educaticn on how tolerance masks clinical signs of intoxication for the chronic drinker. BACs should be measured especially in the obtunded where no history (symptoms) can be given by the patient.
ACCESSION #
88948135

 

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