You say "intravenous fliuds have no effect on blood ethanol clearance".
True. No treatment wakes the patient up either, especially when tested
under double-blind conditions. But interventions such as prodding the
patient, setting up a drip and sticking a needle into them are guaranteed
to arouse the patient to some degree. I believe that this is the reason
why many people think that "remedies" given to the patient are effective,
for the simple reason that any intervention involving physical stimulation
raises the level of consciousness. One of the earliest examples was a
letter to the BMJ in 1953 where it was claimed that intravenous
Parentrovite caused alcohol intoxicated patients to wake up. Many people
took up the idea after that, but it was all based on anecdote. Hope this
answer helps.
At 09:14 10/01/00 PST, you wrote:
>>Do you all use IVF in all alcohol intoxicated patients? what IVF? When and
>>Why?
>>What are the other first line management in these patients? What are your
>>worrys most about?
>
>I'd be interested to hear what the "elders and wisers" on the list have to
>say on this topic. Apparently, "Intravenous saline has no effect on blood
>ethanol clearance." Li J, Mills T, Erato R, J Emerg Med 1999
>Jan-Feb;17(1):1-5
>
>I often feel a temptation to give fluids to the *presumed* intoxicated, for
>the (very bad) reason that if they perk up on the fluids, I can be reassured
>that intoxication alone is the cause of their depressed mental state. But
>the risk is that a "trial" of fluids subtly starts to take the place of a
>proper assessment, delaying the diagnosis of the head injuries,
>hypoglycaemics and hypothermics until "that drunk bloke in 4 still hasn't
>woken up despite 2L of Dextrose Saline" ...
>
>So, my questions are, if fluids are potentially dangerous, and don't sober
>people up any quicker, why are they so commonly given? Is it just the
>anecdotal evidence that "I hooked my drunken flatmate up to an IV when I was
>an SHO and he managed to do an appendicectomy 3 hrs later"? Or do we just
>care about their hangovers?
>
>Should I stop giving IV fluids? Or should I, too, just resign?
>
>Jon Bury
>SHO / Clinical Assistant
>______________________________________________________
>Get Your Private, Free Email at http://www.hotmail.com
>
>
>
Professor John Henry
Academic Department of Accident and Emergency Medicine
Imperial College School of Medicine
St Mary's Hospital
London W2 1NY
Tel 44-171 886 6187
Fax 44-171 886 6315
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