Journal ArticleDOI
Screening major trauma patients for prevalence of illicit drugs
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TLDR
The low rate of patient refusal and large numbers screened by ED staff suggests that point-of care testing for illicit substances in major trauma is acceptable and feasible, and this study and ongoing surveillance may be used to inform driver education strategies.Abstract:
Introduction Australasian emergency departments (ED) routinely test patient alcohol levels following major trauma, but assessment for illicit drugs is uncommon. Methods A prospective cross-sectional study of major motor-vehicle-related trauma patients attending both adult major trauma centres in Victoria, Australia. All eligible patients had point-of-care saliva testing to determine the prevalence of common illicit drugs. Results Over 12 months, 1411 patients were screened, 36 refused (2.6%) and 63 were excluded. Of the final 1312 cases included, 173 (13.2%; 95% confidence interval 11.5, 15.1) tested positive to at least one illicit substance, with 133 (76.9%; 69.7, 82.8) positive for meth/amphetamines. One in five had more than one illicit substance detected. Patients testing positive were most frequently in motor vehicles (91.9% vs. 85.6%) and least frequently cyclists (2.3% vs. 4.2%) or pedestrians (5.2% vs. 10.3%), compared to those testing negative. They were younger (mean age 35.4 vs. 43.1 years), more likely to arrive overnight (27.2% vs. 12.1%) or after single vehicle crashes (54.3% vs. 42.3%). Although the initial disposition from ED did not differ, those testing positive were more likely to re-present within 28 days (13.9% vs. 5.4%). Discussion and conclusions A high prevalence of potentially illicit substances among patients presenting with suspected major trauma supports the need for urgent preventive strategies. The low rate of patient refusal and large numbers screened by ED staff suggests that point-of care testing for illicit substances in major trauma is acceptable and feasible. This study and ongoing surveillance may be used to inform driver education strategies.read more
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Journal ArticleDOI
Penetrating trauma: Relationships to recreational drug and alcohol use
TL;DR: The most common recreational drugs identified included marijuana, benzodiazepine, opiates, alcohol, cocaine, and amphetamine among patients with penetrating trauma as mentioned in this paper, and positive screens for alcohol and recreational drugs were common among patients in this setting.
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Drug and alcohol intoxication in major trauma: Associations, trends and outcomes over a decade.
TL;DR: In this paper , the authors provide an update on substance-use patterns and their association with traumatic presentation and outcome within a contemporary Australian context, and demonstrate escalating rates of drug intoxication and declining rates of alcohol intoxication prior to trauma.
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Aggression, violence and threatening behaviour during critical illness
Jeffrey J. Presneill,Timothy Fazio,Melissa J Ankravs,Yasmine Ali Abdelhamid,Christopher MacIsaac,Adam M. Deane +5 more
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References
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The prevalence of alcohol, cannabinoids, benzodiazepines and stimulants amongst injured drivers and their role in driver culpability: part ii: the relationship between drug prevalence and drug concentration, and driver culpability.
TL;DR: In this article, the authors examined the relationship between the prevalence and concentration of drugs and the culpability of the driver using an objective method for assessing culpability, and found a significant concentration-dependent relationship between alcohol and culpability: as blood alcohol concentration increased, so did the percentage of culpable drivers.
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Epidemiology of alcohol and other drug use among motor vehicle crash victims admitted to a trauma center.
J. Michael Walsh,Ron Flegel,Leo Cangianelli,Randolph Atkins,Carl A. Soderstrom,Timothy J. Kerns +5 more
TL;DR: Point of collection (POC) test results correlated well with laboratory results and provide important information to initiate rapid intervention/treatment for substance use problems among injured patients.
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Evaluation of four oral fluid devices (DDS®, Drugtest 5000®, Drugwipe 5+® and RapidSTAT®) for on-site monitoring drugged driving in comparison with UHPLC–MS/MS analysis
Sabina Strano-Rossi,Erika Castrignanò,Luca Anzillotti,Giovanni Serpelloni,Roberto Mollica,Franco Tagliaro,Jennifer P. Pascali,Delfina di Stefano,Roberto Sgalla,Marcello Chiarotti +9 more
TL;DR: Evaluated four commercial on-site OF drug screening devices, namely DDS, Drugtest 5000, Drugwipe 5+(®) and RapidSTAT(®), in a real operative context and ketamine was systematically included in the UHPLC-MS/MS confirmatory analysis.
Journal ArticleDOI
The prevalence of drugs in injured drivers
Olaf H. Drummer,Irene Kourtis,Jochen Beyer,Penny Tayler,Martin Boorman,Dimitri Gerostamoulos +5 more
TL;DR: In mid 2009 Victoria introduced compulsory drug testing of blood taken from all injured drivers taken to hospital, with a positive rate for the three drugs prohibited by legislation and drugs of any type were detected in 35% of cases.
Journal ArticleDOI
Risk of severe driver injury by driving with psychoactive substances.
TL;DR: Alcohol still poses the largest problem in terms of driver risk of getting injured among psychoactive substances, but there was a decrease in the risk of severe driver injury with increasing age.