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Boozed patients proving a headache at Auckland City ED

Author
Newstalk ZB / Jamie Morton, NZ Herald,
Publish Date
Fri, 25 Oct 2019, 9:52AM
Booze is a factor in nearly one in 10 injuries dealt with by Auckland City Hospital's emergency department, new research shows. Photo / File

Boozed patients proving a headache at Auckland City ED

Author
Newstalk ZB / Jamie Morton, NZ Herald,
Publish Date
Fri, 25 Oct 2019, 9:52AM

Booze is a factor in nearly one in 10 cases dealt with by Auckland City Hospital's emergency department, new research shows.

A study published today in the New Zealand Medical Journal found that, in the space of just a year, more than 5000 people showed up at the ED with alcohol-related injuries.

These patients were most likely to be men in their 20s and 30s, and to turn up at nights during weekends, public holidays and over the summer months.

The study showed how they were often brought in by emergency services and stayed longer in hospital than other patients.

Yet they also frequently walked out before a doctor could treat them – and in other cases, they had to be forcibly removed.

One recent survey found 92 per cent of ED staff were encountering verbal and physical aggression from drunk patients; for two-thirds of them, that was at least a weekly occurrence.

"EDs have recognised for a long time that alcohol is an issue for their patients and it's always useful if we have some solid data about the size of the problem," said the study's leader, Professor Bridget Kool of the University of Auckland.

"It also means we can monitor trends to tell if things are getting worse or better, or if initiatives are working or not."

Of more than 70,000 cases that Auckland Hospital's ED saw, about 7 per cent were alcohol-related.

And of those patients, two-thirds were men, about half were in their 20s and 30, and 28 per cent came from deprivation.

Māori were also over-represented, accounting for 17 per cent of those cases, despite making up just 8 per cent of Auckland District Health Board's population.

The cases made up 6 per cent of all those seen in evenings, and then 18 per cent of those treated between 11pm and 7am.

Half turned up via emergency services – yet just 8 per cent were classified as having life-threatening injuries.

Once at ED, they stayed there an average five hours – two hours longer than the median stay time.

Kool said some past interventions, such as St John setting up stations in the city, had led to fewer of these cases reaching ED.

Waikato Hospital ED doctor John Bonning said drunk patients continue to be a major problem for his colleagues. Photo / Supplied
Waikato Hospital ED doctor John Bonning said drunk patients continue to be a major problem for his colleagues. Photo / Supplied

"That's not solving the problem, but it's saying that maybe some of these people don't need to go to hospital, because they're a burden on emergency departments."

While the solution to binge drinking largely lay in public health and community efforts, Kool said EDs had run screening trials with patients.

"This is where staff will ask patients about their drinking while they're sitting in an ED and thinking, 'God, that was stupid'.

"They just give them some brief advice and that's been shown to be effective in people's drinking, but these things need to be resourced – and currently, our EDs are already over-burdened."

John Bonning, Australasian College for Emergency Medicine (ACEM) president and Waikato Hospital emergency doctor, said alcohol was likely the most preventable public health issue facing EDs.

"It's an ongoing problem, it's constant and it's certainly not getting better," he said.

"You're just trying to do your best for patients … and to get these drunk people come in with what's essentially a preventable condition, and get physically and verbally abused, it's really, really challenging."

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