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Emergency physicians' opinions on the use of intravenous fluids to treat patients intoxicated with ethanol (alcohol): attitudes of emergency medicine physicians in the North East of England toward the use of intravenous fluids to treat individuals intoxicated with ethanol (alcohol) attending the emergency department compared with the scientific evidence

Lookup NU author(s): Paul Hindmarch, Dr John Wright

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Abstract

Objectives There is an apparent conflict between published evidence and UK emergency medicine (EM) physician practice with regard to the use of intravenous fluids to treat patients intoxicated with alcohol. We conducted a survey of all EM physicians in North East (NE) England to determine opinion with regard to this therapy, and compared this with the available evidence for its benefit. Methods We identified 136 EM consultants and trainees in NE England. Each one was contacted and asked to complete a questionnaire with regard to their opinion on the use of intravenous fluids for intoxicated patients, both with and without head injury. Results The majority (73%) of EM physicians in the NE England use intravenous fluids in their treatment of intoxicated patients. The treatment used varies, but the most commonly used fluid is 0.9% saline (volume range, 500-3000 ml; mean, 1300 ml). Fewer respondents (52%) would use intravenous fluids if the patient had suffered an apparent head injury. Conclusion The use of intravenous fluids to treat intoxication is common practice among EM physicians in NE England. The available literature states that this practice is futile. However, there are significant limitations in these studies. This suggests that EM physicians might be using intravenous fluids therapy (IVT) because they are finding in their own practice it is effective. We hypothesize that IVT should improve care in most intoxicated patients as the result of a direct dilutional effect. Further research is required to establish the validity of existing EM physician's practice of using IVT. European Journal of Emergency Medicine 19:379-383 (C) 2012 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.


Publication metadata

Author(s): Hindmarch PN, Land S, Wright J

Publication type: Article

Publication status: Published

Journal: European Journal of Emergency Medicine

Year: 2012

Volume: 19

Issue: 6

Pages: 379-383

Print publication date: 01/12/2012

ISSN (print): 0969-9546

ISSN (electronic): 1473-5695

Publisher: Lippincott Williams & Wilkins, Ltd.

URL: http://dx.doi.org/10.1097/MEJ.0b013e32834e909c

DOI: 10.1097/MEJ.0b013e32834e909c


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