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EMS Providers Do Not Accurately Note Motor-Vehicle Crash Patients With Positive Serum Alcohol Concentrations

Published online by Cambridge University Press:  28 June 2012

Ronald F. Maio ,
Audrey Wu ,
Frederic C. Blow  and
Brian Zink
Ronald F. Maio*
Affiliation:
Section of Emergency Medicine, Department of Surgery, University of Michigan, Ann Arbor, Michigan
Audrey Wu
Affiliation:
Section of Emergency Medicine, Department of Surgery, University of Michigan, Ann Arbor, Michigan
Frederic C. Blow
Affiliation:
University of Michigan Alcohol Research Center, Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
Brian Zink
Affiliation:
Section of Emergency Medicine, Department of Surgery, University of Michigan, Ann Arbor, Michigan
*
Section of Emergency Medicine, TC B1354/0303, 1500 E. Medical Center Dr., Ann Arbor, MI 48109-0303 USA
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Abstract

Introduction:

Alcohol use is associated with many motor-vehicle crashes and may increase the severity of injury. Because alcohol use also may mask injury, prehospital emergency care providers (PHECPs) may make inaccurate assessments. To assess and triage crash victims accurately, PHECPs must identify recent alcohol use.

Study Objective:

This study examines the accuracy of PHECPs in identifying motor-vehicle crash victims who had positive serum alcohol concentrations.

Design:

Retrospective cohort study.

Population:

Included in the study were motor-vehicle crash victims more than 17 years of age who were conveyed directly to a university medical center emergency department by ground ambulance (n = 372).

Time Period:

15 July 1990 to 15 July 1991.

Methods:

Data sources included ambulance report forms and hospital records. Variables that were abstracted included the Revised Trauma Score (RTS), the PHECPs' impression of alcohol use, and serum alcohol concentrations. Sensitivity, specificity, predictive-value positive, predictive-value negative, and 0.95 confidence intervals (0.95 CI) were calculated for the PHECPs' ability to identify patients with a serum alcohol concentration >0. The relationship between the RTS and the impressions of alcohol use was analyzed with chi-square testing: a p-value of <0.05 was considered statistically significant.

Conclusion:

This study suggests that tims with positive serum alcohol concentrations. Selection bias and retrospective design are significant limitations of this study. Future studies should develop and evaluate methods to improve PHECPs' accuracy in assessing alcohol use in motor-vehicle crash victims.

Keywords

alcoholalcohol screeningemergency medical servicesfield sobriety testinginjurymotor-vehicle crashprehospital emergency care providertriage
Type
Brief Report
Information
Prehospital and Disaster Medicine , Volume 10 , Issue 2 , June 1995 , pp. 110 - 112
Copyright
Copyright © World Association for Disaster and Emergency Medicine 1995

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Footnotes

*

Presented at NAEMSP, Scientific Assembly, Portland, Oregon, August 1994

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