[Non-hospitalization orders for subjects with presumed alcoholic intoxication]

French law requires all persons in an apparent state of alcoholic intoxication taken into police custody to be examined at hospital to determine whether medical observation is necessary. A do-not-hospitalize order is required to return the person to police custody. We attempted to ascertain the number of orders delivered and the quality of medical management of these persons.

Over a one-month period, 140 persons in an apparent state of alcoholic intoxication and under police custody were seen at the University Hospital emergency ward at Tours, France. Do-not-hospitalize orders were delivered for 131 of them who were returned to police custody. Among the 66 other persons admitted for acute intoxication, 4 were also returned to police custody. Nurse and physician reports were assessed.

The 135 persons, accounting for 12.7% of all emergency ward activity, were predominantly men (96%) and young (mean age 33 years). Many were aggressive (12.7%) and 80% arrived between 6 p.m. and 6 a.m. Nurse records revealed care was less rigorous at night and for the more aggressive subjects. Reasons for delivery of the do-not-hospitalize order were not sufficiently explicit in the physician records.

The large volume of activity involved in caring for these persons and the difficulty encountered in correct medical management, together with legal implications, suggest that medical and paramedical teams need better training for the management of persons in an apparent state of alcoholic intoxication.