What Is the First-Line Treatment of Ethanol Intoxication?

Clinical Scenario

Acute ethanol intoxication presents with impaired mental status. In patients without a history or evidence of trauma and without other concerning clinical features, first-line management can be initiated with close observation rather than immediate advanced investigation.

Treatment Approach

First-line care is supportive, with the specific components determined by the patient's clinical presentation — including their hydration status and other metabolic findings at the time of assessment.

The full decision algorithm, including all regimen components and criteria, is available via the structured protocol below.

Clinical Goal

The primary target is improvement of mental status on frequent reassessment. This watchful-waiting approach guides management and limits the need for further workup when the clinical picture remains stable.

Instant Access to Structured Evidence-Based Regimens

References

Oral fluid is generally sufficient to provide adequate hydration, though clinically dehydrated patients may benefit from crystalloid fluid replacement.
Patients without a history or evidence of trauma and who do not demonstrate other concerning clinical features can be managed with frequent reassessments to verify improvement of mental status; this "watchful waiting" approach limits CT utilization but is resource intensive.

DOI: 10.1016/j.jemermed.2023.01.010

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