Feature

Up to a quarter of ED presentations are alcohol-related: Report


Evelyn Lewin


6/12/2018 1:32:46 PM

‘Emergency departments are becoming like pubs’: One in four weekend emergency department presentations at St Vincent’s Hospital Melbourne occurred following alcohol consumption.

ACEM’s research found that 90% of emergency physicians have experienced alcohol-related violence.
ACEM’s research found that 90% of emergency physicians have experienced alcohol-related violence.

The peak body for emergency medicine in Australia and New Zealand, the Australasian College for Emergency Medicine (ACEM), has released findings from an ongoing study to identify sources of harm arriving at hospitals that involve alcohol consumption.
 
ACEM found that, over a three-month period earlier this year, one in 10 patients presented to St Vincent’s Hospital Melbourne emergency department after drinking alcohol.
 
That number soared to one in four on weekends.
 
‘Emergency departments are becoming like pubs,’ ACEM Fellow Professor Diana Egerton-Warburton, who is the lead on ACEM’s Alcohol Harm in the ED Program, said.
 
‘Our research shows that nine out of 10 emergency physicians have experienced alcohol-related violence.
 
‘With the sheer volume of alcohol-related presentations to emergency departments, policy makers need to urgently address the issue of affordability and availability of alcohol.’
 
Alcohol-related injuries at the St Vincent’s Hospital Melbourne emergency department related to assaults, glassings, and violence resulting in soft tissue injury and fractures. Other attendances related to acute intoxication leading to nausea and vomiting, unconsciousness, and alcohol-attributed mental health presentations.
 
‘Emergency physicians are on the frontline and regularly witness the devastating effects of excessive alcohol consumption on individual health and wider communities, and often experience assaults or verbal and physical threats from drunk patients,’ ACEM President Dr Simon Judkins said.
 
‘That one in four patients in St Vincent’s Hospital Melbourne emergency department on weekends are there because of alcohol shines a light on just how pervasive the harms from drinking are.
 
‘All of this is incredibly confronting and really adds to the stress and burnout of an emergency medicine workforce already under pressure.’
 
In the lead-up to the Christmas and new year period, ACEM Fellow Dr Andrew Walby, who works at St Vincent’s Hospital Melbourne emergency department, said there is a ‘heightened expectation’ of the challenges emergency physicians will face.
 
The length of trading hours at venues selling alcohol contribute to the issue, Dr Judkins said.
 
‘We know that trading hours are part of the problem, with Victoria’s regulatory environment enabling some of the longest opening hours in Australia, with many venues selling alcohol past 1.00 am in the morning, and entertainment complexes like Crown [Casino] allowed to trade for 24 hours.’
 
Dr Judkins’ concern is echoed in the data, which showed the leading venues at which people were last served alcohol before presenting to St Vincent’s emergency department were the Crown Casino, the Melbourne Cricket Ground (MCG), music club Tramp Bar, the Arbory Bar and Eatery on the Yarra River, and live music venue Billboard on Russell Street.
 
In response to this data, the Alcohol Policy Coalition (APC) is calling for greater controls to protect against alcohol-fuelled harms.
 
‘Ending your night in a hospital emergency department is not a great night out, and our hospitals should not be spending so much of their time and resources dealing with alcohol-caused injuries and illnesses – things that could easily be avoided if alcohol businesses were better regulated,’ APC spokesman Dr Mark Zirnsak said.
 
‘Venues are clearly continuing to serve people who are intoxicated, which is leading to people needing emergency assistance at our hospitals.
 
According to the APC, the sale of alcohol kills nearly 6000 Australians from disease every year, including 1300 Victorians; causes eight different types of cancer; and results in more than 3200 people developing cancer every year. 
 
Recent figures from the Australian Bureau of Statistics show Australia’s average rate of alcohol consumption is the lowest it has been since 1961–62. Despite this, the Australian Institute of Health and Welfare’s (AIHW) Impact of alcohol and illicit drug use on the burden of disease and injury in Australia found that alcohol causes 4.6% of all disease burden, one third of which is attributable to alcohol dependence.
 
The RACGPs Smoking, nutrition, alcohol and physical activity (SNAP) guidelines state that, for healthy men and women, drinking no more than two standard drinks on any day reduces the lifetime risk of harm from alcohol-related disease or injury.



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