Signing Intoxicated students

[katbemeEMT-B]

I am looking for opinions on signing intoxicated college students. In the last couple of years, there have been several deaths due to alcohol poisoning at surrounding colleges. This has heightened the response of the colleges in our area when they encounter an intoxicated student. They immediately call 911, requesting EMS. We arrive on scene to find the normal vomiting young college student that basically needs to sleep it off. The downfall is that this takes our truck out of service not once, but several times a night, (especially on Friday - Sunday nights). Recently, we have been signing many of these students instead of transporting them as long as a friend, who is not intoxicated, can care for them. What would you do or how would you handle this?

[Niftymedi911]

Transport.....transport.....transport......... how do you know that all he needs is to "sleep it off" can you say your 100% certain of that...... No?? Don't "assume" it's a mistake that can cost you your job. And in the state of Florida if I let someone who's that drunk sign off stating they didnt want to go to the hospital..... I'd be breaking the law somethin fierce and liable for anything that happens to him/her.

U know what the say about assuming..... It's the mother of all f***-ups

[tskstorm]

I am looking for opinions on signing intoxicated college students. In the last couple of years, there have been several deaths due to alcohol poisoning at surrounding colleges. This has heightened the response of the colleges in our area when they encounter an intoxicated student. They immediately call 911, requesting EMS. We arrive on scene to find the normal vomiting young college student that basically needs to sleep it off. The downfall is that this takes our truck out of service not once, but several times a night, (especially on Friday - Sunday nights). Recently, we have been signing many of these students instead of transporting them as long as a friend, who is not intoxicated, can care for them. What would you do or how would you handle this?

Intoxication rules out the ability to Refuse Medical Aid/Attention.

Especially if they are college students under the age of 21... If they refuse to go to the hospital, police should be involved.

When in doubt call Med control.

If you want to reduce OOS (out of service) times, transport multiple patients at once.

Problem with you signing them to a sober friend is... if something does go wrong the sober friend will say to the judge "but the EMT's evaluated him and i trusted their opinion based on their assessment that he didn't need to go to the hospital and would be okay if he just went to sleep" as the sober friend has no medical training they have nothing to go off of, except your opinion.

On a note about your general demeanor, you should never have "rule out intoxication" as a primary presumptive diagnosis. You should never assume alcohol is involved despite obvious trends, and obvious 'evidence.' You need to rule out many other things...

AEIOU TIPS

A - alcohol, anoxia(more hypoxia than anoxia)

E - epilepsy

I - insulin (diabetes)

O - overdose

U - uremia, under dose of Rx Med

T- trauma

I - infection

P - psychiatric

S - stroke (cardiovascular)

Just to name a few.

[emtannie]

Recently, we have been signing many of these students instead of transporting them as long as a friend, who is not intoxicated, can care for them. What would you do or how would you handle this?

I like your answer tskstorm...

I see several scary things with this as well.

As mentioned above, you are allowing someone with decreased LOC to sign off - never a good thing.

You are also abandoning care to someone of lower training, or now training, by leaving that person in the care of a friend. If anything were to go wrong, you would be held liable.

Yes it is frustrating to have several calls like this a night... but it is a necessary evil of our jobs...

Maybe your department can put together an informational/educational session on the dangers of alcohol poisoning and provide it to the college? This is obviously becoming quite an issue if you are there several times a night... and maybe you can get some college bigwigs on side to work on it, if they realize that it is putting you OOS for other calls... just a thought...

[katbemeEMT-B]

I don't disagree, that is why I am looking for opinions on the subject. So let me ask you this, would you transport these students ALS or BLS? On a medic/EMT-B truck, would you put the medic in back or the EMT?

sidenote: the medic does the on-scene assessment of the student.

[katbemeEMT-B]

Maybe your department can put together an informational/educational session on the dangers of alcohol poisoning and provide it to the college? This is obviously becoming quite an issue if you are there several times a night... and maybe you can get some college bigwigs on side to work on it, if they realize that it is putting you OOS for other calls... just a thought...

This is something that I have been thinking about quite a lot lately. The college includes an alcohol awareness session with orientation, but apparently they aren't getting through to the kids. I think that maybe if information came from EMS, they might take it much more serious.l

It does scare me that this is becoming such a problem as my daughter is only a few years away from entering college and if I had to choose the college that would be prefect for the degree she will be seeking, it would be one of the ones that we transport from often.

[Eydawn]

Your campus needs an organization like my campus has. It's a student run EMS service where the EMT's have a medical director and their focus is education and providing basic care and assessments at parties and in dorm rooms.

They focus on the alcohol stuff. Purely volunteer, they take turns being on "drunkwatch" so that the borderline folks who are really drunk and feel like hell but don't have alcohol poisoning can avoid hospital bills, etc.

I'm not in this one. I have too much to do to be able to watch drunks for free. But I think it's better than taking a unit out of service and it provides an option for folks who would be too scared to call real EMS.

You might suggest it to your campus heads...

Wendy

CO EMT-B

[tskstorm]

I don't disagree, that is why I am looking for opinions on the subject. So let me ask you this, would you transport these students ALS or BLS? On a medic/EMT-B truck, would you put the medic in back or the EMT?

sidenote: the medic does the on-scene assessment of the student.

All runs should be ALS until proven otherwise ... They should treat it as any other altered mental status patient.

Until you can rule out everything that can cause an altered mental status patient you should not assume he is just intoxicated.

[reaper]

When you work a college town, this is part of the job.

You can give up on getting the college bigwigs to push education on the issue. Hell, they are pushing to lower the drinking age. What makes you think they care about educating the kids?

It does tie up a lot of your service and a lot of ED beds. But, there is nothing you can do. I worry less about alcohol poisoning and more about aspiration, in these Pt's!

[tskstorm]

When you work a college town, this is part of the job.

You can give up on getting the college bigwigs to push education on the issue. Hell, they are pushing to lower the drinking age. What makes you think they care about educating the kids?

It does tie up a lot of your service and a lot of ED beds. But, there is nothing you can do. I worry less about alcohol poisoning and more about aspiration, in these Pt's!

I worry more about being vomited on, or my truck vomited in!