Forensic Nursing in the ER; Diagnosing Life Threatening Alcohol Consumption

The ER staff was summoned to the ER entrance. Several guys were surrounding the back end of a van. Spread out in the area that usually houses a backseat was a 21-year-old male (OG) who “drank too much”. His friends brought him for evaluation because they were starting to get scared. OG had been drinking all day long. He “passed out” and began breathing very slowly.

The ER staff pulled OG out of the back of the van by a backboard and took him into the ER. IV’s were started, activated charcoal and Narcan were given, and his airway was secured by nasal intubation. After being stabilized, the patient was transferred to a tertiary care center.

The next morning, OG was extubated and was released home. OG had no recollection of how detrimental his actions were. Unfortunately, he may repeat these actions again. Next time, he may never wake up.

It is important to know that when a patient presents with an acute onset of respiratory depression that the amount of alcohol ingested was due to the rapid consumption. Typically, alcohol that is ingested is eliminated within an hour. Respiratory depression may lead to death if not corrected. Those patients who are chronic drinkers are able to tolerate larger amounts of alcohol without having life threatening symptoms.

If you were working in an ER, how would your usual method of contributing to diagnosis change after having read this?

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