RESUMEN

The evaluation of acute alcohol impairment is an important basis for evaluating the physiological and psychological status of patients and judging their treatment and nursing measures.There is a large number of research on acute alcohol impairment by foreign researchers,but there are few relevant research reports in China.This article reviews the origin,development and the evaluation tools of acute alcohol impairment in the context of emergency treatment,and summarizing its advantages and disadvantages by comparing the content,evaluation methods,applicable population,reliability and validity of each evaluation tool,in order to provide scientific references for the evaluation,treatment and nursing care of acute alcohol impairment for emergency departments in China.

RESUMEN

This study aimed to investigate the predictors of recidivism in first-time driving under the influence (DUI) offenders, analyzing variables derived from medico-legal and toxicological examinations. The research was structured as a comparative study for the period 2012-2019. DUI offenders with a blood alcohol concentration >0.5 were included in the study. The case group consisted of recidivist offenders, while the comparison group consisted of first-time offenders. Personal data, socioeconomics, and parameters linked to the DUI were compared between the two groups. Significance was determined by chi-square and Mann-Whitney tests. To prevent confounding effects, multivariate binary logistic regression analysis was performed. Our sample encompassed 1678 subjects (196 in the case group, 1482 in the comparison group). Gender, driving license category, education, and tobacco use resulted in significant differences between the groups. In a model including age at DUI, education, and smoking habit as independent variables, higher educational levels (high school, bachelor's) and older age protected against recidivism, whereas smoking >20 cigarettes/day was an independent risk factor for recidivism. Recidivist offenders have specific characteristics indicating different therapeutic programs and carefulness in driving license regranting. A higher tobacco consumption in recidivists suggests that the use of this substance could influence the risk of DUI for reasons that will need to be explored.

Asunto(s)

RESUMEN

BACKGROUND: There is no formal assessment to determine level of disability in the millions of patients with alcohol-induced impairment who present to emergency departments annually. Hack's Impairment Index (HII) is a standardized, serializable clinical tool designed to quantify ability. Nursing staff members at this center perform the HII and determine a score using paper prompts. OBJECTIVE: We developed an HII electronic application and investigated whether or not an electronic version on a mobile device would affect nursing performance. METHODS: A chart review-based quality improvement project compared the number, repetitions, and completeness of HII score documentation performed by nurses over 6.5 months. Group 1: paper-based HII scores for the 90-day period before intervention; group 2: iPad-based HII scores for the 90 days after intervention. There was a 2-week period for staff training and electronic version feedback between groups. Informal, ad hoc interviews were performed with nurses at investigation termination. RESULTS: Group 1: 476 emergency department patients with alcohol-induced impairment had HII scores ordered; 339 (71.2%; 95% CI, 67.1, 75.3%) had HII assessments with a total of 539 HII scores documented. An average (SD) 1.60 (0.01) serial assessments occurred per patient, 5 (1.1%; 95% CI, (0, 2.2%) scores were incomplete. Group 2: 569 alcohol-induced impairment emergency department patients were seen and had HII scores ordered; 420 (73.8%; 95% CI, (70.2, 77.4%) had HII assessments with a total of 639 HII scores documented. An average (SD) 1.52 (0.03) serial assessments occurred per patient, 4 (0.9%; 95% CI, (0.81, 0.99%) had incomplete HII scores. CONCLUSIONS: Although our study took place at 1 center, was a chart review, and not directly observed, we found that the mobile device-based HII application to determine a score did not interfere with nursing performance. Specifically, the repetition and completeness of nursing assessments of emergency department patients with impairment from alcohol use was not altered when comparing paper chart documentation with electronic format documentation. (Curr Ther Res Clin Exp. 2021; 82:XXX-XXX).

RESUMEN

BACKGROUND: Although restrictive state alcohol policy environments are protective for individuals' binge drinking, research is sparse on the effect of alcohol policies on alcohol's harms to others (AHTO). We examined the lagged associations between efficacy of U.S. state alcohol policies and number of harms from others' drinking 1 year later. METHODS: Individuals with AHTO data in a nationally representative sample of U.S. adults (analytic sample n = 26,744) that pooled the 2000, 2005, 2010, and 2015 National Alcohol Surveys and a 2015 National Alcohol's Harm to Others Survey were linked with prior-year state policy measures. We used 2 measures from the Alcohol Policy Scale (APS)-effectiveness in reducing (i) binge drinking and (ii) impaired driving, based on experts' efficacy judgments regarding 29 state alcohol policies. Three 12-month AHTO measures (due to another drinker) were experiencing: (i) either family/marriage difficulties or financial troubles; (ii) being assaulted or vandalized; and (iii) passenger with drunk driver or traffic accident. Multilevel models accounting for clustering within states and stratified by age-groups (<40 vs. ≥40) examined associations between the APS and AHTO measures, controlling for individual covariates (gender, race, education, employment and marital status, family problem-drinking history) of the victim. RESULTS: Only for those aged <40, the lagged APS-Binge drinking and APS-Impaired driving scores were each inversely associated with aggression-related harms and, separately, with drunk driving-related harm from someone else's drinking (ps < 0.05 to < 0.01). Family/financial harms were not associated with APS scores for either age-group. Composite AHTO measures (any of 3 harm-types) also were inversely associated with stronger state alcohol policy environments (ps < 0.05 to <0.01). CONCLUSIONS: State alcohol policies may be effective in reducing, to a meaningful degree, aggression-related harms and vehicular hazards due to other drinkers, but mainly in those under 40.

Asunto(s)

RESUMEN

OBJECTIVE: The annual rate of impaired driving crashes in the United States has remained nearly constant over the last decade. While engineers, educators, enforcement, and emergency response personnel have worked diligently in their combined efforts to reduce the loss of life, there is still significant progress to be made. One area of recent interest is the use of data driven enforcement. The basis for data driven enforcement is the use of statistical clustering to identify geographic areas that represent the location of problem identification for various criminal or traffic offenses. In the case of impaired driving fatalities, the clustering represents locations with high rates of impaired driving crashes. Law enforcement officers and supervisors may allocate resources towards more specifically and efficiently addressing problem areas. METHODS: While data driven enforcement has been proven to be an effective tool in addressing crime and traffic safety problems, it has been a slow process for agencies to adopt data driven techniques. This study aims to explore the difference in traffic stops made inside and outside of hotspot identified areas. The study uses data from the Stark County Operating a Vehicle Impaired Task Force between 2013 and 2014. RESULTS: The analysis determined that stop occurring in hotspot defined areas are more likely to result in impaired driving arrests and seatbelt citations. Additionally it is found that the average cost of impaired driving arrests is significantly cheaper for stops occurring inside of hotspot areas. CONCLUSION: Clustering as a means of directing law enforcement efforts are a way to increase the productivity and benefits of law enforcement agencies with limited finances or personnel. From this study it is seen that traffic stops made within defined cluster or hot spot areas are more effective in resulting in OVI arrests.

Asunto(s)

RESUMEN

BACKGROUND: The presence of alcohol or other substances of abuse in blood or urine from injured patients is often used as a proxy for substance influence at the time of injury. The aim of this study was to obtain an estimate of substance influence at the time of injury based on blood concentrations of alcohol and other substances of abuse, and to explore the relationship between the substance prevalence at the time of admittance to the hospital and the actual influence at the time of the injury. METHODS: The study included all adult patients admitted to the emergency department of a university hospital during 1 year (n = 996). Quantification in blood was done by an enzymatic method for alcohol, and by liquid chromatography-mass spectrometry or gas chromatography-mass spectrometry for 28 other substances of abuse. Concentrations of alcohol and other substances in blood at the time of injury were calculated. The degree of influence was assessed on the basis of the calculated blood concentrations, with a threshold of influence set at a blood alcohol concentration (BAC) of 0.05 %, or a substance concentration leading to an influence similar to that of a BAC of 0.05 %. RESULTS: A total of 324 patients (32.5 %) were determined to be under the influence at the time of injury. In comparison, 394 patients (39.6 %) had one or more substances above the cut-off limit in blood at the time of admittance to the hospital. Alcohol was the most prevalent substance causing influence at 25.9 %. Among patients with violence-related injuries, almost 75 % were under the influence of alcohol and/or substances. Patients under the influence were younger, and men were more often under the influence than women. More patients were under the influence at nighttime and during weekends than at daytime and on weekdays. CONCLUSIONS: About one third of the injured patients were determined to be under the influence at the time of injury, with alcohol being the most prevalent substance causing influence. Approximately 98 % of the patients with alcohol detected in blood at the time of admittance to the hospital were under the influence of alcohol at the time of injury.

Asunto(s)

RESUMEN

The National Transportation Safety Board recently recommended that states establish a per se blood alcohol concentration (BAC) limit of 0.05 or lower for all drivers who are not already required to adhere to lower BAC limits in a national effort to reduce alcohol-impaired driving. There is strong evidence for adopting this recommendation. A comprehensive review of the literature on BAC limits was conducted. The research indicates that virtually all drivers are impaired regarding at least some driving performance measures at a 0.05 BAC. The risk of being involved in a crash increases significantly at 0.05 BAC and above. The relative risk of being killed in a single-vehicle crash with BACs of 0.05-0.079 is 7-21 times higher than for drivers at 0.00 BAC. Lowering the BAC limit from 0.08 to 0.05 has been a proven effective countermeasure in numerous countries around the world. Most Americans do not believe a person should drive after having two or three drinks in 2 hours. It takes at least four drinks for the average 170-pound male to exceed 0.05 BAC in 2 hours (three drinks for the 137-pound female). Most industrialized nations have established a 0.05 BAC limit or lower for driving. Progress in reducing the proportion of drivers in fatal crashes with illegal BACs has stalled over the past 15 years. Lowering the BAC limit for driving from the current 0.08 to 0.05 has substantial potential to reduce the number of people who drink and drive in the United States and get involved in fatal crashes.

Asunto(s)

Asunto(s)

RESUMEN

BACKGROUND: Alcohol is the leading contributor to boating deaths. Earlier literature estimates that 30-40% of people drink alcohol while boating. OBJECTIVE: The objective of this study was to directly approach boaters at the dock to assess the prevalence of alcohol consumption while boating, as well as their knowledge of alcohol impairment. METHODS: This was a cross-sectional survey of a convenience sample of boaters aged 21 years and older at Illinois lakes and rivers during July 2011. Participants completed a survey of alcohol use and impaired boating knowledge consisting of six multiple-choice questions. A χ(2) analysis was used to assess knowledge differences by demographic variables. RESULTS: Two hundred and ten people participated. Less than one fourth of participants correctly answered 4 of the 5 knowledge questions. Eighty-four percent correctly reported the watercraft blood alcohol legal limit. Eighty-one percent erroneously believed that it was more dangerous for the driver to be intoxicated than the passenger. There were no differences in knowledge by sex, education, boat ownership, or driver status. Seventy-six percent admitted to drinking alcohol while boating. Younger participants (aged 21 to 40 years) were significantly more likely to report drinking while boating compared with older participants (p < 0.05). CONCLUSIONS: A majority of participants imbibe while boating and with only a rudimentary understanding of the dangers. Designated drivers (for boating) campaigns might falsely imply imbibing-passenger safety. Public health officials should readdress the dangers of passenger drinking, especially with the younger age group, to help decrease alcohol-related morbidity and mortality.

Asunto(s)