I don’t think the paper suggests that this protocol be implemented in an ER to evaluate all inebriated patients. Should there be a suspicion of ABS, it would be

I don’t think the paper suggests that this protocol be implemented in an ER to evaluate all inebriated patients. Should there be a suspicion of ABS, it would be appropriate to refer for further outpatient management. This would be the case with any other differential diagnoses. In addition, the authors are clinicians who likely have had plenty of ER experience in their training.