Medline Plus published a report of a study this morning with very interesting information about drunks and emergency rooms.  It seems that ambulance workers are not working off a checklist and they may be able to safely reroute drunken patients to detox centers instead of emergency rooms.  In 2004 it was estimated that 0.6 percent of all US ER visits were made by people without any problems other than just being drunk.  You want to know what those visits cost?  About $900 million.  WOW!  So in Colorado researchers found no serious medical problems being reported after 138 people were sent to a detox center to sleep it off, instead of to an ER.  Dr. David Ross, the study’s lead author from Penrose ST. Francis health Services said, “Part of the issue has been – as it is in many busy ER departments – there’s a lot of chronic alcoholics that are brought in by ambulance, police or just come in.  Often they are brought in because they have not committed a crime or there is limited space in our detoxification center.  So the majority were brought to the ER department.  Ambulance Company where I serve as medical director created the checklist with the help of the local detox center and that provided limited medical care by a nurse, and the local hospitals to reduce the number of drunks without medical needs being sent to the local ERs.” Sometimes alcohol abusers are in need of rehab programs.

On this checklist there is 29 yes or no questions, one question is, the patent being cooperative with the ambulance worker’s exam.  Is the patient willing to go to the detox center?  If the patient said no the ambulance driver bought him to the ER.  Well that is good.  For one moment there I thought people were being routed to detox even though they did not want to.  And when you are drink you can’t actually make a good rational decision.  Here is more data on that subject.

Researchers looked at patients they transported between December 2003 and December 2005 wanting to see if any of them ended up having serious medical problems at the detox center.  They transported 718 drunks, the detox center received 138 and the local ERs got 580.  This is the result; 11 of the patients who were taken to detox were turned away because there was no room, their blood alcohol level exceeded the limit, their family came to pick them up or they were combative.  Another 4 patients at the detox center were to the ER because of minor complications including chest and knee pain.  No serious complications reported.  Ross said, “We really believe that we did not miss anybody with a serious illness and injury that didn’t go the ER as they should have.  We tried to estimate how likely we would have been to encounter a serious event.  We estimated at most we’d encounter three serious adverse events in the 748.”

Back to my comment on routing someone drunk to detox.  I do believe that a person should choose what detox center they go to and they should be given that choice when they are sober.

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