September 2005, Volume 35 Number 9 , p 28 - 28
King, Joan E. RN,C, ACNP, ANP, PhD; Schofield, Carin RN, ACNP, MSN
At my hospital, the staff frequently cares for trauma patients who were intoxicated at the time of admission and surgery. What should we expect during their hospitalization?—H.C., ORE
Joan E. King, RN,C, ACNP, ANP, PhD, and Carin Schofield, RN, ACNP, MSN, reply: As with any trauma patient, start by assessing his level of consciousness and ABCs. Protecting the airway is a top priority: An intoxicated patient is at risk for vomiting because alcohol irritates the stomach and can trigger the brain's emetic center. If he vomits, he's at high risk for aspiration.
Also monitor him closely for hypomagnesemia and hypokalemia linked to alcohol abuse, which increase his risk of cardiac arrhythmias. Place him on a cardiac monitor and administer magnesium and potassium supplements as ordered. Obtain a sample for a serum blood alcohol level.
Administer thiamine as ordered to reduce the risk of Wernicke's ...