Alcohol Withdrawal Case Study (45 min)

The patient is a 45-year-old male who is a “frequent flyer” in the emergency room for abdominal pain. The patient always has a high ETOH level and demands to be given 3 macaroni and cheese dishes, 2 chicken sandwiches and 2 whole milk cartons. Vital signs are as follows:

HR 103

RR 20

BP 125/67

Temp 98.6°F orally

SpO2 98%

The patient reports he drank 2 pints of liquor and a 6-pack of beer tonight.  The patient is telling the nurse that he is serious this time and is going to quit drinking for the holidays so that his family will let him come over for Christmas. The patient is slurring his speech and has a history of trying to elope from the hospital.

The patient has an IV line, labs are drawn and the patient has their meal. The blood alcohol level comes back 395 mg/dL. The nurse knows that the patient will metabolize 100 mg/dL every four hours and that the patient is no longer legally intoxicated once it falls to less than 80 mg/dL.

The patient has been in the hospital for 14 hours now and is no longer legally intoxicated. The vital signs have stabilized and the patient is alert and oriented x4. The patient remains hopeful to stop drinking and is asking for additional help to stay sober.