Acute alcohol intoxication. Treatment approach for adults and adolescents

The approach to alcohol intoxicated patients is a demanding issue for German emergency departments. Due to the increasing number of emergency departments, a higher concentration of this patient subset is seen there. Currently, there are no guidelines for the treatment of intoxicated patients in emergency departments; thus, treatment varies depending on hospital infrastructure and local medical decision-making. The purpose of this work is to give precise instructions for the treatment of alcohol intoxicated patients based on current data and the European curriculum for emergency medicine. We thereby hope to contribute to the professional education of emergency physicians in Germany. We performed a systematic review of the literature in German and English using the terms alcohol intoxication, alcohol withdrawal delirium, alcoholism, binge drinking and emergency department as well as the related data concerning therapy, complications, epidemiology and guidelines. Alcohol intoxication is a clinical picture of its own and, therefore, requires the attention of the emergency physician. Well-trained staff, specialized physicians, and infrastructural preparation are necessary to adequately monitor the patient, prevent and detect complications, and create a safe environment for patients and staff. Moreover emergency rooms function as sentinel departments when treating alcohol intoxicated patients. Thus, the initial approach includes acute care aspects, while for those admitted to the hospital, special attention must be given to addiction medicine principles. Preventive medicine aspects need to be considered prior to discharging the patient home.