ALCOHOL-RELATED INJURIES AMONG ADOLESCENTS IN THE EMERGENCY DEPARTMENT

Study objective: To determine the frequency of positive alcohol readin gs in adolescent patients presenting for treatment of injury. Design: Patients aged 10 through 21 years were prospectively enrolled in this descriptive study, Demographic data and information about the injury w ere collected at enrollment. Blood ethanol concentration was measured with a saliva alcohol assay with a lower detection limit of 10 mg/dL ( 2 mmol/L). Setting: Enrollment was conducted at four emergency departm ents, an urban trauma center, an urban children's trauma center, a sub urban hospital, and a rural hospital. Enrollment at each facility was conducted during two 24-hour periods for every day of the week (14 day s total). Consecutive sampling was used during each enrollment period. Results: We enrolled 295 patients (92% of eligible subjects). Sixty-t hree percent were male; 74% were white, 19% black, 3% Hispanic, 1% Asi an, and 3% from other racial groups. The mean age was 15.6+/-3.2 years . Fifteen patients (5%) tested positive for ethanol (range, 10 to 120 mg/dL [2 to 24 mmol/L]). Only four of these patients underwent ethanol testing as part of their medical evaluations. Of the 125 subjects age d 17 through 21 years, 14 (11.2%)tested positive for ethanol. Hospital distribution was (number of patients with positive ethanol test resul ts): urban trauma center, 8 of 52; urban children's trauma center, 0 o f 91, suburban hospital, 4 of 111, rural hospital, 3 of 41. The highes t percentage of positive ethanol test results was found at the urban t rauma center, where 15% of total subjects and 22% of subjects aged 17 through 21 tested positive. Injuries related to assaults and motor veh icle crashes were particularly associated with alcohol use. Conclusion : Alcohol is associated with injuries in urban, suburban, and rural se ttings in the older pediatric population. Alcohol use is underrecogniz ed and should be considered in patients presenting with injuries, espe cially victims of assaults or motor vehicle crashes.