Acute EtOH

Used to objectively quantify intoxication when exam is unreliable, especially with altered mental status, trauma, or suspected co‑ingestions. BAC helps detect occult impairment missed clinically (10% false‑negatives in ED patients 1) and avoids misattributing symptoms in chronic drinkers, where signs correlate poorly with BAC 2. Guides disposition, monitoring intensity, and identifies patients likely to have AUD, as 79% screen positive after detectable BAC in ED visits 3.

Monitor airway–breathing–circulation, check glucose, exclude trauma, co‑ingestants, and aspiration risk. Severe intoxication can cause respiratory depression, coma, hypothermia, and asphyxiation from vomiting 1 [Level III evidence]. Correct hypoglycemia and electrolyte derangements; avoid unnecessary intubation if no trauma (GCS <6 alone insufficient) 2 [Level III evidence]. Screen for withdrawal risk and give thiamine early 3 [Level II evidence]. Ensure safe discharge and AUD referral.