I think the rationale behind the IV fluid challenge is that drunks wake up
when the bladder's full. If I had to change the sheets I might have more
reservations, but then it was a senior ED nurse who told me
Steve Meek
three mails in one day, thats my record
> ----------
> From: Jon Bury[SMTP:[log in to unmask]]
> Sent: 10 January 2000 17:14
> To: [log in to unmask]
> Subject: Re: IVF in intoxicated pts
>
> >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
> ______________________________________________________
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