A 49-year-old man with alcohol use disorder arrives confused and ataxic. Triage acuity is ESI 2; BP 132/78 mm Hg, HR 112/min, glucose 66 mg/dL. He

Question

A 49-year-old man with alcohol use disorder arrives confused and ataxic. Triage acuity is ESI 2; BP 132/78 mm Hg, HR 112/min, glucose 66 mg/dL. He has horizontal nystagmus and poor nutrition. IV dextrose is being prepared. Which of the following is the most important immediate intervention?

Accepted Answer

Give IV thiamine before or with dextrose

Answer

Give haloperidol and discharge

Answer

Withhold glucose until MRI is completed

Answer

Start oral multivitamins next week

Answer

Perform lumbar puncture as the first step

Wernicke encephalopathy — ABEM Board MCQ

A 49-year-old man with alcohol use disorder arrives confused and ataxic. Triage acuity is ESI 2; BP 132/78 mm Hg, HR 112/min, glucose 66 mg/dL. He has horizontal nystagmus and poor nutrition. IV dextrose is being prepared. Which of the following is the most important immediate intervention?