0
November 4, 1988, Vol 260, No. 17 >
ARTICLE | November 4, 1988

The Emergency Department Surveillance of Alcohol Intoxication After Motor Vehicle Accidents FREE

Grace Chang, MD, MPH; Boris M. Astrachan, MD
[+] Author Affiliations

This work does not reflect either the opinions or the policy of the Veterans Administration or the Robert Wood Johnson Foundation.

Reprint requests to Department of Psychiatry, Yale University School of Medicine, 34 Park St, New Haven, CT 06519.


JAMA. 1988;260(17):2533-2536. doi:10.1001/jama.1988.03410170081038
Text Size: A A A
Published online
Article
References

To assess the surveillance of alcohol intoxication by surgical house staff, we examined the charts of 346 motor vehicle accident patients who presented to the trauma center of an urban teaching hospital emergency department. Half of the charts were reviewed before and half were reviewed after June 1986, when Connecticut enacted PA86-345, a law changing court rules of evidence so that the analysis by a hospital of a patient's blood could be used to establish probable cause for driving while under the influence of an intoxicant. We predicted and found no change in house-staff practice after passage of the law, since information about intoxication was obtained for immediate treatment. The rate of testing remained constant at 25%, with the median alcohol concentration at 200 mg/dL. Not one patient was referred for alcohol abuse evaluation or treatment. We recommend more vigorous attempts to evaluate, diagnose, and refer patients who abuse alcohol since they threaten the public health.

(JAMA 1988;260:2533-2536)

REFERENCES

1 +
Polen MR, Friedman GD:  Automobile injury— selected risk factors and prevention in the health care setting . JAMA 1988;;259:76-80.
2 +
Waller PF, Stewart JR, Hansen AR, et al:  The potentiating effects of alcohol on driver injury . JAMA 1986;;256:1461-1466.
3 +
Luma GK, Maier RV, Sowder L, et al:  The influence of ethanol intoxication on outcome of injured motorcyclist . J-Trauma 1984;;24:1.
4 +
Lundberg GD:  Ethyl alcohol—ancient plague and modern poison . JAMA 1984;;252:1911-1912.
5 +
Motor vehicle accidents: Injured drivers—use of blood samples in DWI prosecution, 1986, Connecticut public act 86-345.
6 +
Zindema GD, Rutherford RB, Ballinger WF:  Psychiatric management of acute trauma , in The Management of Trauma , ed 4. Philadelphia, WB Saunders Co, 1985;, p 813.
7 +
Baxt WG:  Head trauma , in Trauma, the First Hour . East Norwalk, Conn, Appleton-Century-Crofts, 1985;, p 72.
8 +
Cowley RA, Conn A, Dunham CM:  Medical management , in Trauma Care, Volume II: Medical Management . Philadelphia, JB Lippincott, 1987;, p 201.
9 +
Niven RG:  Alcoholism—a problem in perspective . JAMA 1984;;252:1912-1914.
10 +
Shires GT:  Anesthesia considerations , in The Principles of Trauma Care . New York, McGraw-Hill International Book Co, 1985;, p 65.
11 +
Reyna TM, Hollis HW, Hulsebus RC:  Alcohol-related trauma: The surgeon's responsiblity . Ann Surg 1985;;201:194-197.
12 +
Abram HS, McCourt WF:  Interaction of physicians with emergency ward alcoholic patients . Q J Stud Alcohol 1963;;25:679-688.
13 +
Corten P, Pelc I:  Alcoholics and drug addicts at the emergency room of the hospital . Acta Psychiatr Belg 1986;;86:103-110.
14 +
Silverman JJ, Peed SF, Goldberg S, et al:  Surgical staff recognition of psychopathology in trauma patients . J Trauma 1985;;25:544-546.
15 +
Solomon J, Vanga N, Morgan JP, et al:  Emergency-room physicians recognition of alcohol misuse . J Stud Alcohol 1980;;41:583-586.
16 +
Rund DA, Summers WK, Levin M:  Alcohol use and psychiatric illness in emergency patients . JAMA 1981;;245;1240-1241.
17 +
Walsh ME, Macleod DAD:  Breath alcohol analysis in the accident and emergency department . Injury 1983;;15:62-66.
18 +
Chang G, Astrachan BM:  Identification and disposition of trauma patients with substance use or psychiatric illness . Conn Med 1987;;51:4-6.
19 +
Colquitt M, Fielding LP, Cronan JF:  Drunk drivers and medical and social injury . N Engl J Med 1987;;317:1262-1266.
20 +
Waller JA:  State liquor laws as enablers for impaired driving and other impaired behaviors . Am J Public Health 1986;;76:787-796.
21 +
Mason MF, Dubowschik M:  Alcohol, traffic, and chemical testing in the United States: A resumé and some remaining problems . Clin Chem 1974;;20:126-140.
22 +
Yates DW, Hadfield JM, Peters K:  The detection of problem drinkers in the accident and emergency department . Br J Addict 1987;;82:163-167.
23 +
AMA Council on Scientific Affairs:  Alcohol and the driver . Conn Med 1986;;50:548-554.
24 +
Gibb K:  Serum alcohol levels, toxicology screens, and use of the breath alcohol analyzer . Ann Emerg Med 1986;;15:349-353.
25 +
American College of Emergency Physicians:  The emergency physician's role in behavioral emergencies . Ann Emerg Med 1987;;972:163-164.
26 +
Dans PE:  Alcoholism: Defeatism in medical centers . Hosp Pract 1987;;22:16.
27 +
Skinner HA, Holt S, Schuller R, et al:  Identification of alcohol abuse using laboratory tests and a history of trauma . Ann Intern Med 1984;;101:847-851.
28 +
Christoffel T:  Using road blocks to reduce drunk driving: Public health or law and order? Am J Public Health 1984;;74:1028-1030.
29 +
National Highway Traffic Safety Administration: Facts on Alcohol and Highway Safety . Dept of Transportation, 1983;, p 2.
30 +
Soderstrom CA, Cowley RA:  A national alcohol and trauma center survey . Arch Surg 1987;; 122:1067-1071.

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
Polen MR, Friedman GD:  Automobile injury— selected risk factors and prevention in the health care setting . JAMA 1988;;259:76-80.
2 +
Waller PF, Stewart JR, Hansen AR, et al:  The potentiating effects of alcohol on driver injury . JAMA 1986;;256:1461-1466.
3 +
Luma GK, Maier RV, Sowder L, et al:  The influence of ethanol intoxication on outcome of injured motorcyclist . J-Trauma 1984;;24:1.
4 +
Lundberg GD:  Ethyl alcohol—ancient plague and modern poison . JAMA 1984;;252:1911-1912.
5 +
Motor vehicle accidents: Injured drivers—use of blood samples in DWI prosecution, 1986, Connecticut public act 86-345.
6 +
Zindema GD, Rutherford RB, Ballinger WF:  Psychiatric management of acute trauma , in The Management of Trauma , ed 4. Philadelphia, WB Saunders Co, 1985;, p 813.
7 +
Baxt WG:  Head trauma , in Trauma, the First Hour . East Norwalk, Conn, Appleton-Century-Crofts, 1985;, p 72.
8 +
Cowley RA, Conn A, Dunham CM:  Medical management , in Trauma Care, Volume II: Medical Management . Philadelphia, JB Lippincott, 1987;, p 201.
9 +
Niven RG:  Alcoholism—a problem in perspective . JAMA 1984;;252:1912-1914.
10 +
Shires GT:  Anesthesia considerations , in The Principles of Trauma Care . New York, McGraw-Hill International Book Co, 1985;, p 65.
11 +
Reyna TM, Hollis HW, Hulsebus RC:  Alcohol-related trauma: The surgeon's responsiblity . Ann Surg 1985;;201:194-197.
12 +
Abram HS, McCourt WF:  Interaction of physicians with emergency ward alcoholic patients . Q J Stud Alcohol 1963;;25:679-688.
13 +
Corten P, Pelc I:  Alcoholics and drug addicts at the emergency room of the hospital . Acta Psychiatr Belg 1986;;86:103-110.
14 +
Silverman JJ, Peed SF, Goldberg S, et al:  Surgical staff recognition of psychopathology in trauma patients . J Trauma 1985;;25:544-546.
15 +
Solomon J, Vanga N, Morgan JP, et al:  Emergency-room physicians recognition of alcohol misuse . J Stud Alcohol 1980;;41:583-586.
16 +
Rund DA, Summers WK, Levin M:  Alcohol use and psychiatric illness in emergency patients . JAMA 1981;;245;1240-1241.
17 +
Walsh ME, Macleod DAD:  Breath alcohol analysis in the accident and emergency department . Injury 1983;;15:62-66.
18 +
Chang G, Astrachan BM:  Identification and disposition of trauma patients with substance use or psychiatric illness . Conn Med 1987;;51:4-6.
19 +
Colquitt M, Fielding LP, Cronan JF:  Drunk drivers and medical and social injury . N Engl J Med 1987;;317:1262-1266.
20 +
Waller JA:  State liquor laws as enablers for impaired driving and other impaired behaviors . Am J Public Health 1986;;76:787-796.
21 +
Mason MF, Dubowschik M:  Alcohol, traffic, and chemical testing in the United States: A resumé and some remaining problems . Clin Chem 1974;;20:126-140.
22 +
Yates DW, Hadfield JM, Peters K:  The detection of problem drinkers in the accident and emergency department . Br J Addict 1987;;82:163-167.
23 +
AMA Council on Scientific Affairs:  Alcohol and the driver . Conn Med 1986;;50:548-554.
24 +
Gibb K:  Serum alcohol levels, toxicology screens, and use of the breath alcohol analyzer . Ann Emerg Med 1986;;15:349-353.
25 +
American College of Emergency Physicians:  The emergency physician's role in behavioral emergencies . Ann Emerg Med 1987;;972:163-164.
26 +
Dans PE:  Alcoholism: Defeatism in medical centers . Hosp Pract 1987;;22:16.
27 +
Skinner HA, Holt S, Schuller R, et al:  Identification of alcohol abuse using laboratory tests and a history of trauma . Ann Intern Med 1984;;101:847-851.
28 +
Christoffel T:  Using road blocks to reduce drunk driving: Public health or law and order? Am J Public Health 1984;;74:1028-1030.
29 +
National Highway Traffic Safety Administration: Facts on Alcohol and Highway Safety . Dept of Transportation, 1983;, p 2.
30 +
Soderstrom CA, Cowley RA:  A national alcohol and trauma center survey . Arch Surg 1987;; 122:1067-1071.

Letters

Submit a Letter
CME Course for:


You need to register in order to view this quiz.


To understand the clinical management of acute heart failure syndromes.
Accreditation Information The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians.
The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
To view and print your certificate and access a summary of your CME courses go to My CME.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Compression-Only CPR: Pushing the Science Forward
Cone
AAM 2010;304:1493-1495.
All you need to read in the other general journals
BMJ 2010;341:c5893-c1494.
Submit a Response

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

© 2012 American Medical Association. All Rights Reserved.
Powered bySilverchair Information Systems