Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre

ObjectivesAlthough alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in pat...

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Bibliographic Details
Published in:BMJ open Vol. 8; no. 11; p. e024190
Main Authors: Erdogan, Mete, Kureshi, Nelofar, Karim, Saleema A, Tallon, John M, Asbridge, Mark, Green, Robert S
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 01.11.2018
BMJ Publishing Group
Subjects:
Alcohol use
Emergency Medicine
Emergency services
Epidemiology
Injuries
Intervention
Patients
Recidivism
Trauma
Trauma care
Trauma centers
Young adults
Canada
United States > US
Nova Scotia Canada
alcohol testing
trauma management
ISSN:2044-6055, 2044-6055
Online Access:Get full text
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Summary:ObjectivesAlthough alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in patients requiring trauma team activation (TTA) for whom blood alcohol testing was mandatory, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing.DesignRetrospective cohort study.SettingTertiary trauma centre in Halifax, Canada.Participants2306 trauma patients who required activation of the trauma team.Primary outcome measureThe primary outcome was the rate of BAC testing among TTA patients. Trends in BAC testing over time and across patient and injury characteristics were described. Multivariable logistic regression examined patient-level, injury-level and system-level factors associated with testing.ResultsOverall, 61% of TTA patients received BAC testing despite existence of a mandatory testing protocol. Rates of BAC testing rose steadily over the study period from 33% in 2000 to 85% in 2010. Testing varied considerably across patient-level, injury-level and system-level characteristics. Key factors associated with testing were male gender, younger age, lower Injury Severity Score, scene Glasgow Coma Scale score <9, direct transport to hospital and presentation between midnight and 09:00 hours, or on the weekend.ConclusionsAt this tertiary trauma centre with a policy of empirical alcohol testing for TTA patients, BAC testing rates varied significantly over the 11-year study period and distinct factors were associated with alcohol testing in TTA patients.
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ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2018-024190