Metabolize to Freedom On-Site Not in the ER?

June 20, 2018

Written by Clay Smith

Spoon Feed
An on-site alcohol sobering facility reduced EMS transports to local EDs by over 50% during a local multi-day mass gathering event.

Why does this matter?
Observing intoxicated patients until sober requires time and space in overcrowded EDs.  Most patients are just drunk, though a tiny fraction have serious illness.  Would it work to have a safe place near a mass gathering venue for patients to be observed and sober up rather than transporting to the ED?

“Wupert, your pwastered!” Elmer Fudd
This EMS system developed a sobering facility adjacent to a Professional Golfers’ Association tournament venue in Arizona.  Each day about 180,000 people attended and many drank a lot of alcohol.  The on-site facility consisted of a 20×20 foot tent, staff, nearby local law enforcement, and could accommodate up to 20 people.  Patients were observed until ambulatory, tolerating liquids, and safe transportation was available.  This decreased EMS transports to the local ED by 53% (the primary outcome) but did not change ED volume or ED length of stay.  This was likely due to other factors, such as overall increases in ED volume already occurring in that city and nationally.  This was a novel and safe way to reduce EMS transports and had very low cost by simply reallocating some of the personnel already working the event to staff the sobering facility.

Source
Impact of a Mass Gathering Alcohol Sobering Facility on Emergency Resources.  Prehosp Emerg Care. 2018 May-Jun;22(3):326-331. doi: 10.1080/10903127.2017.1380093. Epub 2018 Jan 3.

Reviewed by Thomas Davis