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Up to one in three attendances to Emergency Departments are alcohol related in Australia

Jan 2nd 2014 at 8:48 PM

A snapshot survey taken at 92 Emergency Departments (EDs) across Australia at 2am last Saturday morning has revealed that 1 out of 7 patients attended as a result of the harmful use of alcohol; in some hot spots as many as I in 3 were alcohol related. Researchers from the Australasian College for Emergency Medicine (ACEM) conducted the survey, which provides the first national glimpse at the amount of alcohol presentations being treated in our EDs, especially over the festive season. "Until now, we've had anecdotal evidence that the rates of alcohol presentations are high, but little prospective data to go on", says Dr Diana Egerton-Warburton, chair of the ACEM Public Health Committee and a principal investigator for the study.

"The survey response rate from the EDs was a remarkable 84%, which demonstrates how keen emergency physicians and staff are to highlight the substantial number of patients they are treating in EDs due to excessive alcohol consumption," said Dr Egerton-Warburton. "Emergency physicians are sick and tired of dealing with the 'bloody idiots' who drink alcohol in excess and end up in the ED. If you work in an ED with 1 in 3 patients affected by alcohol, it's more like a pub than a hospital. This is intolerable for staff and unfair on other patients."

"Imagine attending an ED with a sick child or elderly relative and having your care disrupted or delayed by a person affected by alcohol," suggests Dr Egerton-Warburton. "This happens on a regular basis in our EDs". Future research will aim to validate these results over longer sample periods and quantify the disruptive effect on other patients attending the ED. "This survey indicates that alcohol can put over 400 people in Australian hospital Emergency Departments at any one time", comments principal investigator Professor Drew Richardson, "and this could be the equivalent of a toxic spill or a natural disaster arriving at our EDs, but this is entirely preventable". Dr Lai Heng Foong, an emergency physician from New South Wales, says that ED staff are regularly confronting alcohol-related harm head on, managing the acute and chronic complications of alcohol, and dealing with patients who are often violent and aggressive because of their alcohol use.

"The main issue here is that all the injury and illness caused by alcohol is completely preventable. However, the problem with drinking alcohol in excess is that it's still a socially acceptable pastime," Dr Foong says. Dr Anthony Cross, president of ACEM, is keen to see even more discussion around the damage of excessive alcohol consumption, and the effects not only on the individual, their family and the community, but the dedicated and already overworked emergency department staff who are dealing with this on a daily basis. ACEM would like to be part of a coordinated effort to urgently address this massive public health issue.

All public health interventions need to be considered, including supply and pricing. For example, previous research from New South Wales has demonstrated a significant reduction in assaults and injury with earlier closing times of licensed venues. "We all know excessive consumption of alcohol can cause major harm but it's becoming clearer just how big the problem is," comments Dr Cross. "Drinking to the point that you end up in an Emergency Department happens regularly but it shouldn't be seen as a social norm; it is not just being a bit of a larrikin, it's stupidity."

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