Observation and patient disposition after ethanol intoxication
Admit patients with clinical features of severe or life-threatening ethanol intoxication or who have a complicated ethanol intoxication (eg require intubation; have a history [or clinical signs] of trauma).
Observe patients with mild or moderate ethanol intoxication without complications; patients can be discharged when they are oriented and cooperative, ambulant, eating and drinking, and have passed urine. An individual should not be discharged while marked impairment of cognition or motor function persists. However, it is reasonable to discharge patients with mild intoxication to a safe environment under the supervision of a responsible adult.
Observe any child for at least 4 hours if they have ingested ethanol to detect any hypoglycaemia.
There is no threshold serum ethanol concentration at which discharge can occur—the decision to discharge a patient is made on clinical grounds. However, in children, or adults who are ethanol-naive or use ethanol infrequently, an ethanol concentration of less than 43 mmol/L (0.20%) is generally a requirement for discharge. Adult patients deemed safe for discharge can still be over the legal limit for driving at the time of discharge and should be advised of this.
Patients with ethanol dependence may develop withdrawal symptoms while the serum ethanol concentration is decreasing. For management of withdrawal symptoms, see Overview of alcohol withdrawal management.
Consider referral to a drug and alcohol service for the management of hazardous, harmful or dependent use of alcohol (see Overview of disorders of alcohol use).