How drunk are you?

So, we have this game…well, it’s kind of a sick game, where we bet on what someone’s blood alcohol level (BAC) is going to be. Those of your in law enforcement will probably be old pros at this one. If it’s a first timer that no one has seen before then we’re all pretty much shooting in the dark. But, if it’s a frequent flyer to the ER and you’ve got a track record as to how well tuned their liver is, you can usually guess within about 20 or 30 points.

Now a BAC of 80 mg/dL is equivalent of a 0.08 g/dL on a breathalyzer test used by departments of public safety for DUIs. In the medical paradigm we don’t use the decimal, just a number between 1 and whatever. So, a BAC of 80 means you’re to drunk to drive. Actually at 40 you’re technically drunk. Above 200 is considered toxic. But I’ve seen folks who are over 400 who can still walk and talk! Now those are some REALLY super charged livers! Livers who are screaming cirrhosis death chants, but who for now are really operating at amazing levels. So this little gal comes in the other night, claiming a head injury while incarcerated the day before. She is as coherent, alert, and oriented as the Stake President with abdominal pain in Trauma Bay 9. But I think MY BAC was probably 40 just from being in the same room as her! When asked about the strong (and I mean STRONG) smell of alcohol on her breath, she states one of the conditions of her probation is to abstain from all forms of the evils of booze, and that the smell is simply Mtn. Dew…now I know that there are a lot of different flavored soft drinks, but, last I knew Mtn Dew didn’t make a flavor named Jack Daniels! So we start taking guess on her BAC: My guess was 130. Not even close:278 baby! One of the nurses guessed 280! Yeah, this girl was a regular at the Emergency Room. You might remember the 15 year old I saw a while back who was comatose with a BAC of 330? Not little miss 278, her liver was a Formula One Alcohol Processing Machine…On it’s way to an implosion! She didn’t get any drugs for her headache either.

Pretty wild night tonight. Three subdural hematomas, one of whom was LifeFlighted north in a hurry, a little girl with tetanus of all things, and a strangulated hernia that I got to take to the operating room, and be first assist in taking out an eight inch necrotic section of his bowel. He should do well though: No diabetes, No hypertension, no infection. Man, as much as I love the ER, I miss surgery a lot!

Well, time to go to beddy bye! Let me know how all of you are doing!

Love,

Bartman