Tags

Type your tag names separated by a space and hit enter

Relationship between blood alcohol concentration and observable symptoms of intoxication in patients presenting to an emergency department.
Alcohol Alcohol 2013 Jul-Aug; 48(4):386-9AA

Abstract

AIMS

Clinical and medico-legal decisions often require knowledge of alcohol impairment that is not necessarily revealed by an individual's appearance, and in turn, may not necessarily reflect level of blood alcohol. This study compares 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 to 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 patient's BAC. Relation to measured BACs was assessed by correlation.

RESULTS

BACs ranged from 0 to 418 mg/100 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/100 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 education 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.

Authors+Show Affiliations

Department of Laboratory Medicine and Pathology, Hennepin County Medical Center, University of Minnesota School of Medicine, Minneapolis, MN 55415, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Observational Study

Language

eng

PubMed ID

23690233

Citation

Olson, Kalen N., et al. "Relationship Between Blood Alcohol Concentration and Observable Symptoms of Intoxication in Patients Presenting to an Emergency Department." Alcohol and Alcoholism (Oxford, Oxfordshire), vol. 48, no. 4, 2013, pp. 386-9.
Olson KN, Smith SW, Kloss JS, et al. Relationship between blood alcohol concentration and observable symptoms of intoxication in patients presenting to an emergency department. Alcohol Alcohol. 2013;48(4):386-9.
Olson, K. N., Smith, S. W., Kloss, J. S., Ho, J. D., & Apple, F. S. (2013). Relationship between blood alcohol concentration and observable symptoms of intoxication in patients presenting to an emergency department. Alcohol and Alcoholism (Oxford, Oxfordshire), 48(4), pp. 386-9. doi:10.1093/alcalc/agt042.
Olson KN, et al. Relationship Between Blood Alcohol Concentration and Observable Symptoms of Intoxication in Patients Presenting to an Emergency Department. Alcohol Alcohol. 2013;48(4):386-9. PubMed PMID: 23690233.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationship between blood alcohol concentration and observable symptoms of intoxication in patients presenting to an emergency department. AU - Olson,Kalen N, AU - Smith,Stephen W, AU - Kloss,Julie S, AU - Ho,Jeffrey D, AU - Apple,Fred S, Y1 - 2013/05/19/ PY - 2013/5/22/entrez PY - 2013/5/22/pubmed PY - 2014/1/17/medline SP - 386 EP - 9 JF - Alcohol and alcoholism (Oxford, Oxfordshire) JO - Alcohol Alcohol. VL - 48 IS - 4 N2 - AIMS: Clinical and medico-legal decisions often require knowledge of alcohol impairment that is not necessarily revealed by an individual's appearance, and in turn, may not necessarily reflect level of blood alcohol. This study compares 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 to 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 patient's BAC. Relation to measured BACs was assessed by correlation. RESULTS: BACs ranged from 0 to 418 mg/100 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/100 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 education 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. SN - 1464-3502 UR - https://www.unboundmedicine.com/medline/citation/23690233/Relationship_between_blood_alcohol_concentration_and_observable_symptoms_of_intoxication_in_patients_presenting_to_an_emergency_department_ L2 - https://academic.oup.com/alcalc/article-lookup/doi/10.1093/alcalc/agt042 DB - PRIME DP - Unbound Medicine ER -