> Alcohol impairment goes away after a few hours. I think this is a gross oversimplification. If memory serves, the rate of ethanol metabolism is something ar

> Alcohol impairment goes away after a few hours. I think this is a gross oversimplification. If memory serves, the rate of ethanol metabolism is something around 0.015 (units?) per hour. In my ED, an average BAL for a patient that we realize is intoxicated (and choose to get a level) is probably 0.3 or so. 0.4 - 0.5 is common, and we see nearly 0.8 (in ambulatory patients!) from time to time. So for 0.3, if you are maximally generous and consider "sober" 0.08 (the level for an automatic DUI in my state), you're looking at 15 hours of observation. Not exactly "a few." Further, your own anecdote highlights exactly my point. How you you *know* you had a TBI? Because it felt like one? Because a doctor told you it was one? Because a physician's (subjective) assessment of your exam suggested it was one? Because your insurance would cover an inpatient stay for one if they listed that as the diagnosis? Don't misunderstand, I do a relatively thorough neurological exam compared to my colleagues, but I have no pretenses as to the level of subjectivity in my assessment, or to the external biases that could potentially sway my judgment. A more objective measure would be greatly appreciated, both to help ensure that I was acting in patients' best interest, and frankly to help me compel others to act in appropriate cases.