Use of blood alcohol concentration in resuscitation room patients

Objective: To clarify the use of blood alcohol concentration (BAC) in the emergency department resuscitation room, by comparing it with a subsequent alcohol questionnaire and by surveying patients’ attitudes to BAC testing. Design: Observational study. Participants: 273 resuscitation room patients at St Mary’s Hospital, Paddington between August 2005 and February 2006. Main outcome measures: BAC comparison to questionnaire results, and attitudes to BAC testing. Results: The level of agreement between positive screening by questionnaire and a BAC of >80 mg/100 ml was low (κ = 0.29, 95% confidence interval 0.12 to 0.46) because each test measures different aspects of drinking. Patients accepted the use of BAC tests in detecting alcohol use, though a small minority reported concerns over confidentiality. Conclusion: Use of BAC testing complements later questionnaire screening to identify alcohol misuse in patients initially brought to the emergency department resuscitation room, providing results are fed back to the patient. Potential ethical, judicial and insurance concerns should not prevent the use of BAC when judged to be in the patient’s best interest.