Patients Under The Influence

1
Patients Under The Influence

• Temple College
• EMS Professions

2
Incidence

• Alcohol, drugs involved in
• 50 of all motor vehicle collisions
• 50 of all homicides

Roughly half of all adult trauma patients you
care for will be drunk, stoned, or high!
3
Assessment

• Alterations in
• Level of consciousness
• Pupil responses
• Vital signs
• Pain perception
• Decreased reliability of history
• Decreased cooperation

4
Assessment
The patient is NEVER just drunk!
5
Patient Interaction
The EMT frequently determines whether patient is
cooperative or uncooperative!
6
Patient Interaction

• Positive, nonjudgmental
• Identify yourself
• Ask permission to make physical contact
• Orient, reorient as needed
• Address with respect
• Avoid terms like bub or honey

7
Patient Interaction

• Consider your body language, voice tone
• Remember youre a caregiver, not a cop
• Acknowledge patient concerns, feelings
• Be very clear about what you need, expect
  patients to do

8
Patient Interaction

• History-taking may require closed-ended (yes-no)
  rather than open-ended questions
• Discretely confirm history with family, friends,
  bystanders

9
Uncooperative Patients

• Preplan management protocols with law enforcement
  agencies
• Remember, this population is high risk for
• Hepatitis B
• Hepatitis C
• HIV

10
The patient is NEVER just drunk!
Err on side of caution with intoxicated patients.