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Emergency medicine
Research
Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre
  1. Mete Erdogan1,
  2. Nelofar Kureshi2,3,
  3. Saleema A Karim4,
  4. John M Tallon5,
  5. Mark Asbridge6,
  6. Robert S Green1,2
  1. 1 Trauma Nova Scotia, NS Department of Health and Wellness, Halifax, Nova Scotia, Canada
  2. 2 Departments of Critical Care, Emergency Medicine, and Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
  3. 3 Division of Neurosurgery, Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada
  4. 4 Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
  5. 5 Department of Emergency Medicine, Vancouver General Hospital, University of British Columbia, Vancouver, British Columbia, Canada
  6. 6 Departments of Community Health and Epidemiology and Emergency Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
  1. Correspondence to Dr Robert S Green; greenrs{at}dal.ca

Abstract

Objectives Although 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.

Design Retrospective cohort study.

Setting Tertiary trauma centre in Halifax, Canada.

Participants 2306 trauma patients who required activation of the trauma team.

Primary outcome measure The 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.

Results Overall, 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.

Conclusions At 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.

  • trauma management
  • alcohol testing

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2018-024190

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    Footnotes

    • Contributors MA and JMT conceived the research questions and designed the study. SAK performed data collection. ME, NK, MA and SAK performed analysis and drafted the manuscript. ME, NK, RSG, SAK, JMT and MA contributed to data interpretation, critical review and revisions of the manuscript for important intellectual content. All authors approved the final version of the submitted manuscript and agree to be accountable for all aspects of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval Nova Scotia Health Authority Research Ethics Board.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data available.