Siegfried RS Perez, MD, Emergency Registrar; Gerben Keijzers, MSc (Biomed Health Sci), MBBS, FACEM, PhD Candidate, Staff Specialist, Emergency Physician; Michael Steele, PhD, Statistician; Joshua Byrnes, PhD, Research Fellow; Paul A Scuffham, PhD, Chair in Health Economics, Director of Population & Social Health Research Program.
Intravenous 0.9% sodium chloride therapy does not reduce length of stay of alcohol-intoxicated patients in the emergency department: A randomised controlled trial
Article first published online: 8 NOV 2013
© 2013 The Authors. Emergency Medicine Australasia published by Wiley Publishing Asia Pty Ltd on behalf of Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.
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Emergency Medicine Australasia
Volume 25, Issue 6, pages 527–534, December 2013
How to Cite
Perez, S. R., Keijzers, G., Steele, M., Byrnes, J. and Scuffham, P. A. (2013), Intravenous 0.9% sodium chloride therapy does not reduce length of stay of alcohol-intoxicated patients in the emergency department: A randomised controlled trial. Emergency Medicine Australasia, 25: 527–534. doi: 10.1111/1742-6723.12151
- Issue published online: 5 DEC 2013
- Article first published online: 8 NOV 2013
- Manuscript Accepted: 20 SEP 2013
- Queensland Emergency Medicine Research Foundation
- alcohol intoxication;
- intravenous administration;
- length of stay
I.v. 0.9% sodium chloride (normal saline) is frequently used to treat ED patients with acute alcohol intoxication despite the lack of evidence for its efficacy.
The study aims to compare treatment with i.v. normal saline and observation with observation alone in ED patients with acute alcohol intoxication.
A single-blind, randomised, controlled trial was conducted to compare a single bolus of 20 mL/kg i.v. normal saline plus observation with observation alone. One hundred and forty-four ED patients with uncomplicated acute alcohol intoxication were included. The study was conducted in one tertiary and one urban ED in Queensland, Australia. Primary outcome was ED length of stay (EDLOS). Secondary outcomes were treatment time, breath alcohol levels, intoxication symptom score, level of intoxication and associated healthcare costs.
Both groups were comparable at baseline: blood alcohol content (BAC) was similar between treatment and control groups (0.20 % BAC vs 0.19 % BAC, P = 0.44) as were initial intoxication symptom scores (22.0 vs 22.3, P = 0.90). Both groups had a similar EDLOS (287 min vs 274 min, P = 0.89; difference 13 min [95% CI −37–63]) and treatment time (244 min vs 232 min, P = 0.94; difference 12 min [95% CI −31–55]). Change of breath alcohol levels, intoxication score and level of intoxication were not significantly different between the two groups. Patients in the treatment group had an additional healthcare cost of A$31.92 compared with control.
I.v. normal saline therapy added to observation alone does not decrease ED length of stay compared with observation alone. Intoxication symptom scores and general state of intoxication were similar in both groups. The present study suggests that either approach is reasonable, but observation alone might be preferred as it is less resource intensive.