急診醫療對酒後事故傷害防制的責任和機會

Prevention of Alcohol Problems in Emergency Departments: The Chance and the Responsibility

10.7023/TJFM.200406.0063

李燕鳴(Yin-Ming Li)；胡勝川(Sheng-Chuan Hu)

alcohol-related problems ； emergency departments ； intervention

台灣家庭醫學雜誌

14卷2期（2004 / 06 / 01）

63 - 70

繁體中文

過量飲酒不利健康和慢性病控制外，亦增加事故傷害風險，急診外傷病患較高風險是過量飲酒病患，故急診室是篩檢不當飲酒行為的適當場所。過去國內對急診之交通事故或頭部外傷傷者的研究，也發現飲酒是一項危險因素，但評估傷患之飲酒問題現時仍不是常規性的診療項目，故未能從健康保險資料檔分析酒精與傷害事故之相關性。國外建議應常規評估求診者之飲酒問題，對不當飲酒行為者更應給予諮詢或轉介戒酒服務；本文回顧臺灣地區急診病患之飲酒狀況調查及障礙；簡介美國衛生機構對急診病患篩檢酒精濫用的建議、指引及處理原則，及討論國內這項議題需進一步研討的重點。（台灣家醫誌2004; 14: 63-70）

Excessive alcohol consumption not only has an adverse effect on health and chronic disease, but it also increases the risk of accidents. Patients seen in emergency departments are more likely to be diagnosed with alcohol-related problems. So the emergency department is an ideal setting to identify those with alcohol problems. Previous studies also found that alcohol drinking is a major risk factor associated with vehicle or head injuries. However, alcohol drinking is not regularly assessed nor recorded in emergency departments. Records from National Insurance data bank are not helpful for studying the association of alcohol drinking among injured patients. In Western countries, routine for screening alcohol problems is conducted among emergency department patients. For those who screened positive with alcohol abuse or disorder they should have a consultation, or should be referred to a treatment program. This article reviewed the studies of alcohol detection among emergency patients and the barriers to screening alcohol problems. We also summarize the recommendations and guidelines from the American Health Organization for alcohol screening and brief intervention. Lastly, we suggest that more intensive research is conducted on screening for alcohol problems and prevention programs. (Taiwan J Fam Med 2004; 14: 63-70)

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