Abstract
Objective
Alcohol–intoxicated individuals account for a significant proportion of emergency
department care and may be eligible for care at alternative sobering facilities. This
pilot study sought to examine intermediate-level emergency medical technician (EMT)
ability to identify intoxicated individuals who may be eligible for diversion to an
alternative sobering facility.
Methods
Intermediate-level EMTs in an urban fire department completed patient assessment surveys
for individual intoxicated patients between May and August 2010. Corresponding patient
medical records were retrospectively reviewed for diagnosis, disposition, and blood
alcohol content. Statistical analysis was conducted to determine correlates of survey
response, diagnosis, and disposition; and survey sensitivity and specificity were
calculated.
Results
One hundred ninety-seven patient transports and medical records were analyzed. Emergency
medical technicians indicated 139 patients (71%) needed hospital-based care, and 155
patients (79%) had a primary ethanol diagnosis. Fourteen patients (7%) were admitted
to the hospital, and EMTs identified 93% of admitted patients as requiring hospital-based
care. Overall sensitivity and specificity of the survey were 93% (95% confidence interval,
66.1-99.8) and 40% (95% confidence interval, 33.3-47.9), respectively.
Conclusion
Intermediate-level EMTs may be able to play an important role in facilitating triage
of intoxicated patients to alternate sobering facilities.
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Article Info
Publication History
Published online: November 07, 2011
Accepted:
June 3,
2011
Received:
April 29,
2011
Footnotes
☆Sources of support: This work was supported in part by the Closing the Addiction Treatment Gap Initiative, Open Society Foundations (grant no. 20023067 ).
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.