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Background  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.    Objective  The study aims to compare treatment with i.v. normal saline and observation with observation alone in  ED  patients with acute alcohol intoxication.    Methods  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  Q ueensland,  A ustralia. 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.    Results  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.    Conclusions  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.

emergency medicine australasia

Intravenous 0.9% sodium chloride therapy does not reduce length of stay of alcohol‐intoxicated patients in the emergency department: A randomised controlled trial