DELIVERY OF DO-NOT-HOSPITALIZE ORDERS FOR PERSONS IN AN APPARENT STATE OF ALCOHOLIC INTOXICATION

Objectives: French law requires all persons in an apparent state of al coholic intoxication taken into police custody to be examined at hospi tal to determine whether medical observation is necessary. A do-not-ho spitalize order is required to return the person to police custody. We attempted to acertain the number of orders delivered and the quality of medical management of these persons. Methods: Over a one-month peri od, 140 persons in an apparent state of alcoholic intoxication and und er police custody were seen at the University Hospital emergency ward at Tours, France. Do-not-hospitalize orders were delivered for 131 of them who were returned to police custody. Among the 66 other persons a dmitted for acute intoxication, 4 were also returned to police custody , Nurse and physician reports were assessed. Results: The 135 persons, accounting for 12.7% of all emergency ward activity, were predominant ly men (96%) and young (mean age 33 years), Many were aggressive (12.7 %) and 80% arrived between 6 p.m. and 6 a.m. Nurse records revealed ca re was less rigorous at night and for the more aggressive subjects. Re asons for delivery of the do-not-hospitalize order were not sufficient ly explicit in the physician records. Conclusion: The large volume of activity involved in caring for these persons and the difficulty encou ntered in correct medical management, together with legal implications , suggest that medical and paramedical teams need better training for the management of persons in an apparent state of alcoholic intoxicati on.