No abstract

The prehospital care provider has been limited in his or her initial assessment of patients due to having available only a limited number of simple diagnostic tests. There has not been an accurate field test available to rule out significant ethanol intoxication. We designed a prospective trial for the prehospital setting to test the utility of a rapid, semi-quantitative, saliva alcohol reagent strip for patients with an altered level of consciousness. We found that these strips were useful in ruling out significant ethanol intoxication as a cause of an altered level of consciousness with a sensitivity of 85.7% and a specificity of 94.4%, but were not useful in accurately predicting the blood alcohol level. We conclude that these reagent strips are useful in the prehospital setting to provide information about patients with an altered level of consciousness.

Resuscitology is the science of reanimation from apparent death or from unconsciousness. Prior to the last quarter of this century, resuscitation was steeped in myth, supported only by anecdote, and founded on unphysiologic principles. The development of new, scientifically based, modern concepts and practice of cardiopulmonary resuscitation (CPR) injected great hope into improving the chances for survival and quality of life for cardiac patients.Recent reports indicate that there are nearly 70,000 “successful” cardiac resuscitations annually. However, it is estimated that only 10% are able to resume their former lifestyles. It is anticipated that with the expansion of prehospital emergency medical services, this proportion will increase. These facts have stimulated intense research aimed at elucidating the pathophysiology of cellular death with the goal of protecting the brain during cardiac arrest.