Signing Intoxicated students

[BEorP]

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

Is 21 the age of consent in the US?

[fiznat]

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.

I dont know about this one. I see where you're coming from, but that logic is a slippery slope. Why BLS anything then, if the requirement to do so is the complete exhaustion of every possible serious illness. The "oh but it COULD be..." mindset is one that ignores basic assessment and clinical judgment. Get the vital signs, check the sugar, do a H+PE and pass it on to the EMT. Thats what I do.

As far as getting refusals from drunk kids though, I agree that it is usually inadvisable. It isn't black and white though, as I have in the past obtained refusals from "moderately" intoxicated patients who answered questions correctly and seemed mentally capable. 21 or not, as long as they're over 18 and AXO. I dont understand what the legal drinking age has to do with an adult's ( >18 ) decisions about their health care anyways.

To answer the above poster, yes in the US you need to be 21 to drink. You are an "adult," however, at 18.

[Arizonaffcep]

I dont know about this one. I see where you're coming from, but that logic is a slippery slope. Why BLS anything then, if the requirement to do so is the complete exhaustion of every possible serious illness. The "oh but it COULD be..." mindset is one that ignores basic assessment and clinical judgment. Get the vital signs, check the sugar, do a H+PE and pass it on to the EMT. Thats what I do.

As far as getting refusals from drunk kids though, I agree that it is usually inadvisable. It isn't black and white though, as I have in the past obtained refusals from "moderately" intoxicated patients who answered questions correctly and seemed mentally capable. 21 or not, as long as they're over 18 and AXO. I dont understand what the legal drinking age has to do with an adult's ( >18 ) decisions about their health care anyways.

True, but remember how easy it is to justify an IV (ALS skill in AZ). I personally hate it when a local FD BLS's fractures. That's why we carry morphine. Or even a SZ call when they BLS it. The patient at least warrants an IV. It's just so damn easy to LEGITIMATELY ALS something, it's almost not worth BLSing anyone.

[Arizonaffcep]

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

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!

As I work in what would be considered an "inner city" hospital in Tucson (a HUGE college town), students usually occupy our hallway beds until sober. The biggest thing is without a doubt aspiration (one of the reasons you turn them on their side and give Zofran). ETOH poisoning is rare (but not unheard of). We usually have a couple of cases a year, usually enough to count on one hand (not two hands).

[zippyRN]

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!

from a right pondian persepctive where the legal age to purchase alcohol is 18 ( and 16 in certain circumstances relating to 'on licences' and serving meals ) and the legal age to consume alscohol in private is 5...

Alcohol consuption is an overt and integral part of university soial life, most of the larger residence complexes have alcohol licences and keep to 'pub hours' alcohol sales are a substantial contribution to the income of the Student's unions

because becasue alcohol consumption is legal and overt there are

1. better controls of consumption becasue if you get drunk in the SU or a residence bar you will be facing univesity discipline - so the bar staff are even more confident in enforcing the rules - and backed to the hilt by SU / uni security and in residences he duty Senior Resident / Warden (senior residents are older and usually higher up the course Under grads or post grads, Wardens are docoral students/ post docs or junior academics - the bnefits for both are boost in stipend and cheap accomodation for the cost ofshifts on duty as the face ofthe univerity )

2. less fear of contacting the emergency services as there isn't the issue of underage drinking , just the usual crime related to of legal age drinking ...

3. most 1st years will have been of legal drinking age for anything up to a year ( more if they have taken a year out) so it;s not a new ilicit freedom when out of the direct control of mummy and daddy ... e.g. my birthday is the 1stof october so i turned18 within a couple of weeks of beginning year 13 at school , so at the start of my first year of university i was a few weeks off 19 ...

4. there are cultural isues at play the leftpondians , particualry USAn is very much based on teaching abstinance ?

here's a question how old were yu when you had youfirst parentally santioned alcoholic drink ? i can't answer that becuase i don't remember - it's always been something that happens ... so id guess 4 or 5 - it would only have been a very small amount either of 'english' cider or watered red wine ...

[CBEMT]

I deal with this issue weekly. My service has created a standard form to be filled out (usually after the fact, since we've got it memorized) for any ETOH patients that assists us in determining whether or not a patient with alcohol on board could possibly be allowed to sign a refusal or if they should be transported. There are many exclusionary findings that require transport.

In the past we had an alternate transport destination available to us for the in-betweens that, like the OP suggested, just need to sleep it off somewhere and be supervised. However, this is no longer an option, and any intoxicated patient that is not refusal-capable goes to the ER.

Refusal could, for example, "I thew up once, I feel better, but my friends were worried because they've never seen someone throw up before, so they called."

[katbemeEMT-B]

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

Both colleges have on-site EMS...they're the ones that call us. While they don't mind trying to fix the traumas and bringing back the diabetic, they have no desire to deal with the intoxicated students.

[Eydawn]

Yeah, I mean they need the "we're ready to be alky watchers" type EMS... the one on my campus does nothing but.

Wonderful. So they have it, but it's just a bunch of whackers who think it's appropriate to pawn off drunks on the real paid guys just so they don't have to deal with it. What a bunch of sissies.

Wendy

CO EMT-B

[Timmy]

I don’t know what happens in America but Paramedics in Australia certainly don’t transport every intoxicated kid, it’s more of a police issue.

At the spring racing carnival in Melbourne (horse racing that attracts thousands upon thousands of punters) my volley service runs first aid posts, a field hospital and welfare areas. These welfare areas are for intoxicated individuals to come lye down, rehydrate, work out how there getting home safely, sort out there relation problems ect. There might be 50 camp beds set up in a tent filled to the brim with drunks, I’d imagine a very minor majority (if any) of people admitted to this area receive medical treatment. These centers aim to relieve the pressure from police, security, transport paramedics, emergency departments and patients that actually need first aid in the posts or the field hospital. There staffed with a hand full of first responders and security and stocked with plenty of emesis bags and bottles of water. There implementing this program at bigger concerts/raves and in the Melbourne CBD on Friday/Saturday nights.

[firedoc5]

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

DITTO :puke: