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The current standard of care for ethanol-intoxicated patients with altered mental status presenting without signs of head trauma is to observe them until they are clinically sober — without neuroimaging, unless a specific indication arises or the patient fails to become sober as expected.
To evaluate the safety of this practice, researchers reviewed charts from 5943 patients who presented with suspected ethanol intoxication to two U.S. university emergency departments (EDs). Neuroimaging was eventually performed in 7.8% of the patients, and two had neurosurgical interventions. All other patients appeared to sober up safely and were discharged; follow-up data were not collected on discharged patients.