Severe alcohol intoxication: a study of 204 consecutive patients.

We report a five month retrospective analysis of 204 consecutive patients seen in an adult medical emergency department with blood alcohol concentrations (BAC) in excess of 400 mg/dl. The average BAC was 467 mg/dl with a range of 400-719 mg/dl. In 153 patients (75%) the BAC was 400-500 mg/dl, in 47 patients (23%) the BAC was 500-600 mg/dl and in 4 patients (2%) the BAC was greater than 600 mg/dl. Eighty-eight percent of the patients were oriented to person, place, and time upon questioning, 12% were disoriented or unresponsive to noxious stimuli. None of the four patients whose BAC was greater than 600 mg/dl were initially alert and oriented and only eight of the unresponsive patients had a BAC below 500 mg/dl (p less than .001). Sixteen patients (8%) were admitted. Three of the admissions were for continued unresponsiveness presumed due to ethanol, the other thirteen were for coexistent medical conditions. There were no significant associations between BAC and vital sign abnormalities.