Correlation between Alcohol Use Disorders, Blood Alcohol Content, and Length of Stay in Trauma Patients.

Background: Patients with an alcohol use disorder (AUD) have an increased risk of developing complications during their hospital stays; however, how AUD impacts the length of stay (LOS) and the utilization of hospital resources remains inconclusive.

Aim: This study aimed to identify the associations between AUD, defined by self-reported alcohol consumption, blood alcohol content (BAC), and hospital LOS (HLOS) including intensive care unit (ICU) LOS in the trauma patient population.

Study Design: We conducted a retrospective study analyzing data obtained from 2010 to 2018 at a university-based, level-one trauma emergency department.

Readiness to change and reasons for intended reduction of alcohol consumption in emergency department versus trauma population.

Introduction: The primary objective was to identify the most common reasons for intending to cut back on alcohol use, in emergency department (ED) and trauma patient populations. The secondary objective was to determine the association between reason to cut back on alcohol and education level.

Methods: We conducted the study at a level one trauma center in California between 2008 and 2012.

Characteristics of hospitals diverting ambulances in a California EMS system.

Introduction: While several reports discuss controversies regarding ambulance diversion from acute care hospitals and the mortality, financial, and resource effects, there is scant literature related to the effect of hospital characteristics.

Hypothesis/problem: The objective of this study was to describe specific paramedic receiving center characteristics that are associated with ambulance diversion rates in an Emergency Medical Services system.

Methods: A retrospective observational study design was used.

The impact of state level graduated driver licensing programs on rates of passenger restraint use and unlicensed driving in fatal crashes.

Since 1996, states have been implementing and enhancing their graduated driver licensing (GDL) programs. Increased licensing restrictions could steer new drivers to bypass training and licensing altogether. Unlicensed driving is associated with increased fatal crashes and high-risk behaviors that have been shown to adversely affect passenger safety behaviors like restraint use.

Emergency medicine resident well-being: stress and satisfaction.

Background: Emergency medicine (EM) residents are exposed to many work-related stressors, which affect them both physically and emotionally. It is unknown, however, how EM residents perceive the effect of these stressors on their well-being and how often they use unhealthy coping mechanisms to manage stress.

Aims: To evaluate EM residents' perceptions of stressors related to their overall well-being and the prevalence of various coping mechanisms.

Analysis of mental health substance abuse-related emergency department visits from 2002 to 2008.

Background: Mental health substance abuse (MHSA)-related visits in the emergency department (ED) are a growing concern.

Methods: This study analyzed MHSA ED visits by age, gender, ethnicity, region, season, and duration of stay between 2002 and 2008 using the National Hospital Ambulatory Care Survey (NHAMCS). The authors used descriptive statistics and examined ED length of stay using a generalized linear model with a log link, and compared length of stay for these visits.

Assessment of alcohol use patterns among spanish-speaking patients.

Objective: The objective of this study was to assess drinking patterns of Spanish-speaking patients using a bilingual computerized alcohol screening and brief intervention (CASI) tablet computer equipped with the Alcohol Use Disorders Identification Test (AUDIT).

Methods: This retrospective study was conducted in a tertiary university hospital emergency department (ED) between 2006 and 2010. Data from 1816 Spanish-speaking ED patients were analyzed using descriptive statistics, the chi-square test for independence, and the Kruskal-Wallis rank sum test for comparisons using quantitative variables.

Increased detection of alcohol consumption and at-risk drinking with computerized alcohol screening.

Background: The impact of alcohol use has been widely studied and is considered a public health issue. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) recommends Screening and Brief Intervention and Referral Treatment (SBIRT), but the actual practice in the Emergency Department (ED) is constrained due to limited provider time and financial resources.

Objectives: To assess the effectiveness of alcohol screening using Computerized Alcohol Screening and brief Intervention (CASI) compared to alcohol screening by triage nurse during Medical Screening Examination (MSE) in the ED.

An Analysis of Distance from Collision Site to Pedestrian Residence in Pedestrian versus Automobile Collisions Presenting to a Level 1 Trauma Center.

This study tests the hypothesis that most pedestrian collisions occur near victims' homes. Patients involved in automobile versus pedestrian collisions who presented to the emergency department at a Level I trauma center between January 2000 and December 2009 were included in the study. Patient demographics were obtained from the trauma registry.

Assessment of readiness to change and relationship to AUDIT score in a trauma population utilizing computerized alcohol screening and brief intervention.

Trauma patient readiness-to-change score and its relationship to the Alcohol Use Disorder Identification Test (AUDIT) score were assessed in addition to the feasibility of computerized alcohol screening and brief intervention (CASI). A bilingual computerized tablet for trauma patients was utilized and the data were analyzed using Stata. Twenty-five percent of 1145 trauma patients drank more than recommended and 4% were dependent.

A geographic analysis of collisions involving child pedestrians in a large Southern California county.

Objectives: The goal of this study is to explore the relationship between child pedestrian injuries and socioeconomic characteristics of neighborhoods in the context of local traffic volume.

Methods: Child pedestrian collisions were identified in the data of the California Statewide Integrated Traffic Records System (SWITRS). Nine hundred sixty crashes over a 5-year period were identified, geocoded, and mapped to Orange County census tracts.

Crash injury risk behavior in adolescent latino males: the power of friends and relational connections.

The adolescent Latino male mortality profile is an anomaly when compared to an otherwise more favorable overall U.S. Latino population mortality profile.

Six-month follow-up of computerized alcohol screening, brief intervention, and referral to treatment in the emergency department.

The goal of this observational study was to measure change in alcohol consumption at 6 months following emergency department computerized alcohol screening brief intervention (CASI) and referral to treatment (ED-SBIRT) with integrated brief negotiated interview (BNI) and computer-generated personal alcohol reduction plans. At-risk patients received a BNI by CASI, including personalized feedback, assessment of readiness to change, reasons for cutting down, goal setting, and a printed personal alcohol reduction plan. Alcohol use was assessed by telephone interview 6 months after CASI.

Feasibility of emergency department bilingual computerized alcohol screening, brief intervention, and referral to treatment.

The purpose of this study was to assess the feasibility of utilizing a computerized alcohol screening and intervention (CASI) kiosk in an emergency department (ED). An interactive English and Spanish audiographical computer program, developed for used on a mobile computer cart, was administered to 5103 patients. Patients who screened at risk (19%) also received a fully computer-guided brief negotiated interview (BNI) and a printed personal alcohol reduction plan.

U.S. motor vehicle fatality trends in young Latino males.

The Latino Epidemiologic Paradox describes favorable health profiles for Latinos compared to non-Latino Whites (NLW) despite poverty, low education, and low access to health care. An anomaly to this paradox is increased mortality of Latino adolescent and emerging adult males. Previous research shows motor vehicle crash fatalities bear a considerable proportion of the mortality burden attributed to this anomaly.

Crash injury prediction and vehicle damage reporting by paramedics.

Objective: The accuracy of pre-hospital crash scene details and crash victim assessment has important implications for initial trauma care assessment and management. Similarly, it is known to influence physician perception of crash victim injury severity. The goal of this feasibility study was to examine paramedic accuracy in predicting crash victim injury profile, disability outcome at hospital discharge, and reporting vehicle damage with other crash variables.

Child passenger safety: direction, selection, location, installation.

The most significant risk factor for death and serious injury in a car crash is the failure to use a size-appropriate restraint system. Providing accurate car safety seat anticipatory guidance to families is the standard of care. Guiding families on the best car seat for best protection can be done with the four messages, direction, selection, location, and refer, if needed, to community resources for correct installation.