The emergency department surveillance of alcohol intoxication after motor vehicle accidents.

To assess the surveillance of alcohol intoxication by surgical house staff, we examined the charts of 346 motor vehicle accident patients who presented to the trauma center of an urban teaching hospital emergency department. Half of the charts were reviewed before and half were reviewed after June 1986, when Connecticut enacted PA86-345, a law changing court rules of evidence so that the analysis by a hospital of a patient's blood could be used to establish probable cause for driving while under the influence of an intoxicant. We predicted and found no change in house-staff practice after passage of the law, since information about intoxication was obtained for immediate treatment. The rate of testing remained constant at 25%, with the median alcohol concentration at 200 mg/dL. Not one patient was referred for alcohol abuse evaluation or treatment. We recommend more vigorous attempts to evaluate, diagnose, and refer patients who abuse alcohol since they threaten the public health.