The Effect of a Breath Alcohol Level Measurement on Length of Stay and Clinical Management of Acutely Intoxicated Patients in an Emergency Department

Abstract

Background Alcohol use and misuse is a common occurrence in Australian society with one in seven Emergency Department Presentations being alcohol related. Despite substantial literature on the treatment and management of acute alcohol intoxication there is no consistency in the approach to treatment and diagnosis. With a lack of literature on the use of breath alcohol level measurement as a diagnostic tool and the focus of Australian Emergency Departments being length of stay, this study compares them alongside the additional interventions provided throughout the patient journey in the Emergency Department. Method A retrospective study of patient case notes from the calendar year 2016 was conducted. Five hundred and ninety episodes of care met the inclusion criteria and data was collected from the patient case notes and the Emergency Department computer system. This data included identifying treatment provided, breath alcohol levels, length of stay and demographic data. The data was analysed and then interpreted. Results Results revealed that having a breath alcohol level measurement affected length of stay and interventions in the Emergency Department but the value of that breath alcohol level did not influence length of stay or the interventions provided. This indicates that utilising a breath alcohol measurement for determining whether a person is intoxicated affects patient journey through the Emergency Department, however utilising it to determine how intoxicated a patient is, is unlikely to change their Emergency Department journey.Conclusion This study provides evidence on current practice in an Australian Emergency Department. It showed there was a lack of consistency in approach to treatment of acute alcohol intoxication and suggests some implications to clinical practice for Emergency Department clinicians, and examples of where future research would be beneficial.