急診醫療中檢驗事故傷患之血中酒精濃度的相關因素

Factors Associated with Blood Alcohol Testing among Injured Patients in Emergency Department

10.7023/TJFM.200309.0109

李燕鳴(Yin-Ming Li)

injuries ； blood alcohol testing ； emergency departments

台灣家庭醫學雜誌

13卷3期（2003 / 09 / 01）

109 - 119

繁體中文

急診醫師瞭解飲酒對事故傷害和疾病的影響，但提供醫療照顧外，較少檢驗酒精或通報相關問題。本研究對東部一所醫學中心急診室，自2000年7月至2002年6月兩年外傷診療紀錄分析，內容包括傷患人口學特性、就診時段，外傷登錄機轉、昏迷指數、醫師診斷碼、處置與去向，及酒精濃度檢驗值一併轉為電子檔，並查閱半年期有檢驗酒精濃度之個案病例，調查檢驗血中酒精濃度（簡稱酒測）個案的比例中，探討影響事故傷患有酒測的相關因素。結果22,842份求診紀錄中，酒測比例在全體外傷傷患是6.0%，在年齡18以上者傷患是7.6%，在駕駛者傷者是13.7%；需住加護病房或死亡傷患超過半數未檢驗，八成以上住院或手術治療未檢驗。影響酒測之最重要因素是意識障礙及頭部受傷，檢驗結果發現男性、中年、山地鄉居民和深夜來診者顯著高比例是酒醉，超過半數住進加護病房傷者之酒測結果為陰性。結論是急診外傷傷者進行酒測之比例偏低，未能正確評估外傷事故與酒精的相關性，故規劃急診醫療中常規性飲酒評估是必要。

Emergency physicians are well aware of alcohol's role in the injuries and illnesses that lead to emergency department visits. Though clinicians working in the ED treat patients with alcohol problems, they do not identify or report alcohol's role consistently or completely. We reviewed the records of injuries presented to an emergency department, from July 2000 to June 2002. Electronic data including patients' characteristics, time of visit, injury mechanism, coma scale, ICD-9 diagnosis coding, management and results of blood alcohol testing were collected. A total of 22, 842 records were analyzed. Of the total, 6% received alcohol testing, 7.6% were age 18 or above, and 13.7% were injured drivers. More than 50% patients who were admitted to intensive care unit or were dead received no alcohol testing. Of those who were admitted or needed operation immediately, more than 80% received no alcohol testing. Conscious disturbance and head injuries were important conditions for alcohol testing. Alcohol intoxication was more likely found among the male gender, those who are between the ages of 26 and 45, residents of an aboriginal district and those who made midnight visits. Half of those admitted to the intensive care unit tested negative. A very low proportion of blood alcohol testing among emergency department patients was noted. It is impossible to evaluate the role of alcohol in injuries. Routine alcohol screening integrated in emergency service is crucial.

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