An evaluation of intravenous ethanol in hospitalized patients

Alcohol withdrawal is a serious complication of heavy alcohol use and a condition requiring patient stabilization before initiating surgery or implementing lifesaving procedures for injury. Intravenous ethanol (NE) is used to prevent withdrawal during these maneuvers. This report explores the use and potential problems of this practice in an academic urban medical center. This study was undertaken to improve the treatment of NE recipients in an urban, academic health system providing trauma surgery, and general inpatient services. All 68 patients, identified by a review of the pharmacy database for the period August 1993 through January 1994, received IVE during their stay. A priori outcome measures related to the course of therapy in the selected cases. Of all patients studied, 67.6% were admitted for alcohol-related trauma; 61.8% of IVE recipients had no documented risk factors for delirium tremens (59.5% of these were oriented); 17.6% were discharged on the same day the drip was discontinued; only 17.6% were referred to the alcohol consult team; and, throughout the course of therapy in all cases, pro blood alcohol level (BAL) determinations were recorded in patients' records. The use of NE is associated with potentially serious clinical concerns. We found a high prevalence of alcohol-related admissions, inconsistent NE administration, and a low rate of alcohol consult requests. Guidelines to improve the selection, management, and disposition of NE recipients are suggested. (C) 1998 Elsevier Science Inc.