Feasibility of identification of alcohol intoxication by nurses in emergency departments

Vehicle-related injuries are the major cause of death and injuries in Hualien County, and driving under the influence of alcohol plays a major role in such crashes. From December 1997 to May 1998, we determined the blood alcohol concentrations (BAC) of injured individuals from vehicle crashes at two emergency departments in Hualien. Nurses were asked to record whether the patient presented with an alcohol odor. The accuracy of detection by nurses was assessed from the BAC and groups with increased prevalence were identified for screening. Of 945 patients assessed, 505 (53.4%) tested positive by BAC and 320 (33.9%) were identified with an alcohol odor. With a BAC threshold of more than 50 mg/dL, detection sensitivity was 75.4%, specificity was 90.4%, and accuracy was 85.0% (95% confidence interval: 82.7, 87.3). Patients with an alcohol odor were significantly more likely to be men, aborigines, or head-injured patients. The accuracy of detection showed no significant difference by gender, head injury, or driver status. We suggest that detection of alcohol odor by nurses may be a feasible assessment of the role of alcohol in road traffic accidents. This may provide essential data for injury prevention strategies and programs.