Ethanol abuse is a significant underlying factor in accidental injury. Discrimination of an altered sensorium due to ethanol intoxication from that following brain injury remains a clinical problem which consumes significant diagnostic and therapeutic efforts. Evaluation of the patient population treated after blunt injury at a Level I Regional Trauma Center revealed a 13 per cent incidence of overtriage for suspected head injury, in individuals intoxicated with ethanol. Although this did not represent an overwhelming drain on the center's resources, it remains a substantial problem on a national basis.