Appendix

Conference Background

In June, 2000, NHTSA, ACEP, and the ENA sponsored a national conference titled Developing Best Practices of Emergency Care for the Alcohol-Impaired Patient. During this one-day conference, invited health care professionals worked to define best practices of emergency care for the alcohol-impaired patient. The focus was on treating the harmful and hazardous drinking behaviors of patients who present to the emergency department (ED). This first conference was part of an ongoing Partners in Progress initiative to increase the involvement of health care professionals in transportation issues and to contribute to the national goal of reducing alcohol-related traffic deaths to no more than 11,000 by 2005.

The following recommended best practices were developed to serve as the basis for changing how patients’ alcohol use problems are treated in the ambulance, the ED, and the trauma center.

Recommended Best Practices for Pre-Hospital Professionals

1. Assess the patient(s) and document for signs and symptoms of alcohol use problems and assess the
   environment for alcohol-related risk factors.
   
   
2. Report the information on alcohol use problems (AUPs) to hospital personnel.
   
   
3. Assist with on-scene information and referrals for AUP patients.
   
   
4. Provide care for the alcohol-impaired patient(s) in a professional and non-judgmental manner.
   
   
5. Advocate in the community for public education, prevention programs, public policy and team
   programs for AUPs.
   
   
6. Participate in collaborative research, education, and data gathering to improve the care of patients
   with AUPs.
   
   
7. Integrate alcohol screening and alcohol education into curricula, continuing education, and standards
   for emergency health care professionals.

Recommended Best Practices for Nurses

1. Listen to pre-hospital professionals’ report and elicit patient information indicative of AUP.
2. Identify alcohol-related events in initial assessment of the patient.
3. Perform an assessment using appropriate tools, such as history, physical examination, and screening tools.
4. Document objective findings of assessment, interventions, and plan of care for patient with AUP.
5. Collaborate with health care team to implement interventions, such as brief interventions, discharge planning, and referral.
6. Communicate plan of care to appropriate service, such as physicians, substance abuse counselors, referral agencies, and inpatient caregivers.
7. Provide care for the alcohol-impaired patient(s) in a professional and non-judgmental manner.
8. Advocate in the community for public education, prevention programs, public policy, and treatment programs for AUPs.
9. Participate in collaborative research, education, and data gathering to improve the care of patients with AUPs.
10. Integrate alcohol screening and alcohol education into curricula, continuing education, and standards for emergency health care professionals.

Recommended Best Practices for Physicians

1. Physicians should incorporate screening for AUPs into routine care of injured patients.
   
   
2. Physicians should document history and physical findings consistent with AUPs.
   
   
3. Physicians should provide for a brief intervention for patients who screen positive for alcohol use problems.
   
   
4. Physicians should be aware of state laws and consider the reporting of alcohol use problems in accordance with these laws.
   
   
5. Provide care for alcohol-impaired patient(s) in a professionals and non-judgmental manner.
   
   
6. Advocate in the community for public education, prevention programs, public policy, and treatment programs for AUPs.
   
   
7. Participate in collaborative research, education, and data gathering to improve the care of patients with AUPs.
   
   
8. Integrate alcohol screening and alcohol education into curricula, continuation education, and standards for emergency health care professionals.