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One in four patients has been drinking before arrival at accident and emergency

BMJ Specialty Journals

Saliva alcohol concentrations in accident and emergency attendances 2001; 18: 250-4

One in four patients has been drinking before arrival at accident and emergency, reveals a study in Emergency Medicine Journal. Alcohol was implicated in almost all cases of self-harm, almost half of collapses, half of all assaults, and half of admissions to hospital, the findings show.

A survey was carried out of all new attenders aged 10 and older at an accident and emergency department in a hospital in Inverness, Scotland. Two 24 hour periods for each day of the week were covered for two months from mid February to mid April. Alcohol levels were assessed by saliva sample.

Out of 638 eligible patients, 544 took a saliva test. Evidence of alcohol consumption was found in 122. A further 18 who were drunk refused a test, and a further 14 were too drunk to provide one. Thirteen per cent had the legal limit of alcohol in their system; five per cent had up to twice the legal limit, and a further five per cent had well over twice this amount.

Seven people who tested positive were aged between 10 and 17. Those aged between 41 and 60 were most likely to drink before turning up at A&E.

Ninety four per cent of cases of self harm tested positive for alcohol, so did one in two cases of assault, almost half of those suffering collapse, almost half of those injured in a public place and one in two of those who had to be admitted. A quarter of all "domestic incidents" involved alcohol: in Scotland this is a significant cause of death, and is roughly twice the rate seen in England and Wales.

While men outnumbered women by almost 2:1, alcohol levels between the two sexes were remarkably similar, suggesting that women are now drinking more, and that they tend to suffer alcohol related problems at lower levels of intake than men.


The authors point out that the Highlands of Scotland is an area where excess drinking is a particular problem, but they cite published research in other parts of the UK showing that alcohol is a factor in significant numbers of patients requiring emergency treatment.


Dr Noelle Murphy, Accident and Emergency Department, Raigmore Hospital, Inverness, Scotland.

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