Chang G, Astrachan B M
Department of Psychiatry, Yale University, School of Medicine, New Haven, CT 06519.
JAMA. 1988 Nov 4;260(17):2533-6.
To assess the surveillance of alcohol intoxication by surgical house staff, we examined the charts of 346 motor vehicle accident patients who presented to the trauma center of an urban teaching hospital emergency department. Half of the charts were reviewed before and half were reviewed after June 1986, when Connecticut enacted PA86-345, a law changing court rules of evidence so that the analysis by a hospital of a patient's blood could be used to establish probable cause for driving while under the influence of an intoxicant. We predicted and found no change in house-staff practice after passage of the law, since information about intoxication was obtained for immediate treatment. The rate of testing remained constant at 25%, with the median alcohol concentration at 200 mg/dL. Not one patient was referred for alcohol abuse evaluation or treatment. We recommend more vigorous attempts to evaluate, diagnose, and refer patients who abuse alcohol since they threaten the public health.
为评估外科住院医师对酒精中毒的监测情况，我们检查了346名机动车事故患者的病历，这些患者均被送往一家城市教学医院急诊科的创伤中心。其中一半病历在1986年6月之前进行审查，另一半在1986年6月之后审查，当时康涅狄格州颁布了PA86 - 345号法律，该法律改变了法庭证据规则，使得医院对患者血液的分析可用于确定在受 intoxicant 影响下驾驶的可能原因。我们预测并发现，该法律通过后住院医师的做法没有变化，因为获取中毒信息是为了立即进行治疗。检测率保持在25%不变，酒精浓度中位数为200mg/dL。没有一名患者被转介进行酒精滥用评估或治疗。我们建议更积极地尝试评估、诊断和转介滥用酒精的患者，因为他们威胁到公众健康。
