ALCOHOL-USE AMONG SUBCRITICALLY INJURED EMERGENCY DEPARTMENT PATIENTS

Objectives: To determine the incidence of alcohol use in subcritically injured patients presenting to the ED, by using a saliva alcohol test (SAT) at ED triage during the ED initial assessment; to compare the i ncidence of alcohol use revealed by the SAT with documentation of alco hol use by ED nurses and emergency physicians (EPs) blinded to the SAT results; and to describe the demographics of the SAT-positive, subcri tically injured population. Methods: A blinded, prospective, observati onal evaluation of ED patients presenting with subcritical injuries wa s performed. The patients were tested for alcohol use with an SATI and a subsequent record review was conducted for extraction of demographi c data and evidence of documentation of alcohol use by ED nurses and E Ps blinded to the SAT results. Results: During the study, 798 subcriti cally injured patients had SATs performed. Twenty-one percent of these patients were found to be alcohol-positive by SAT. Either the ED nurs e or the EP documented a clinical impression of alcohol use for 52% of the SAT-positive patients. There were higher SAT-positive rates among men (24%), victims of assault (47%), and patients arriving at night ( 41%). Conclusions: While the SET identified 21% of the subcritically i njured patient population as alcohol-positive, ED nurse and EP documen tation did not identify half of these alcohol-positive patients. Many of these patients may be at risk for additional injuries related to th eir drinking behavior.