You are an SHO working nights in the ED. At 2 am Dublin Fire Brigade ambulance bring in a man who is well known to your Dept. He is a homeless man who struggles with alcohol and substance abuse. You have already seen him twice this week.

Here are your findings on assessment:

Airway: Open and unobstructed

You noted signs of vomit on his clothes

Breathing:  RR 18, Sp02 94% on RA, no wheeze, mild crackles on left side

Circulation: BP 117/86, HR 119, cap refill < 2 sec

Disability:    E2, V2, M5 = 9, moving all 4 limbs, PEARL, you note bruises and a laceration to his left eyebrow (you sutured it 2 nights previously), there are also multiple bruises in various stages of healing over his face, neck and arms.

VBG: pH 7.23, with normal CO2 and O2, lactate 4.6, BM 11.3

1.     What is the recommended alcohol intake for men/ women?

2.     In this case what investigations other than venous blood gas would you order?

3.     What chronic medical conditions are associated with chronic alcohol abuse?

4.     What are symptoms of alcohol withdrawal?