Case
#57 "Party Hearty, Now Sorry!"
by Charlene Babcock Irvin, MD
A
16 y/o male brought by ambulance with chief
complaint of unconsciousness. Per EMS, his
friend called 911 when he couldn’t wake him
up. They had been drinking at his friend’s
home, and they just thought he was drunk.
But, when his friend realized he really
couldn’t wake him up, he became worried.
Family is not available, and friend is not
there. No other history is available.
PE: VS: 135/70, RR=20, HR=105, Sat on 2 L
oxygen=100%.
HEENT: PERRL, roving eye movements. Breath
smells of alcohol. Vomit is noted around the
face. Gag is present. No obvious signs of
trauma to face/scalp, no obvious tenderness
to head/neck area.
HEART: RRR, slightly tachy at 105
Lungs: Clear bilaterally
Abd: Soft, non-tender, BS present Ext: No
bleeding or signs of trauma. Pulses present.
Neuro: No spontaneous eye opening to voice
or pain. He does withdraw to pain and
screams “No.” Reflexes unremarkable.
Strength testing is difficult, but he does
move all four extremities.
AN IV (NS) is ordered, and oxygen is
continued. Patient is placed on a monitor,
(already completely undressed), and blood is
drawn for Ethanol level, lytes, BUN, Cr,
Glucose, CBC. Thiamine, and Folate are also
ordered.
1. What six additional orders should be
considered, and why?
2. What is the elimination rate of alcohol?
Is it different in kids? In chronic
alcoholics?
3. In severe ethanol poisoning, how can you
quickly eliminate the ethanol?
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