title: Are emergency department staffs' perceptions about the inappropriate use of ambulances, alcohol intoxication, verbal abuse and violence accurate?
abstract: OBJECTIVE
  To examine three opinions voiced by nightshift emergency department (ED) staff. First, that a significant proportion of adult patients arriving by emergency ambulance lack a clear indication for emergency transport. Second, that at night a high proportion of ambulance arrivals are drunk, abusive or leave without treatment. Third, that at night a high proportion of ambulance arrivals have been assaulted or have deliberately harmed themselves.
  
  
  METHODS
  A retrospective audit of all 5421 new patient attendances to Glasgow Royal Infirmary ED in February 2007, including 1743 arriving by ambulance.
  
  
  RESULTS
  19.5% of ambulance arrivals lacked a clear indication for emergency transport. Between midnight and 05:00 hours: 52.5% of ambulance arrivals were intoxicated; 6.2% were abusive to staff; 14.0% left before treatment was completed; 21.4% had been assaulted and 7.4% had deliberately harmed themselves.
  
  
  CONCLUSIONS
  The majority of ambulances were called appropriately; however, there remains a significant proportion who could travel by other means. A high proportion of ambulance arrivals between midnight and 05:00 hours were intoxicated, abusive or victims of assault. This supported staff's perception that such patients form a substantial proportion of departmental workload at night.
authors.affiliation: Department of Emergency Medicine, Hairmyres Hospital, East Kilbride, UK. jenvardy@doctors.net.uk
authors.forename: J
authors.initials: J
authors.lastname: Vardy
authors.forename: C
authors.initials: C
authors.lastname: Mansbridge
authors.forename: A
authors.initials: A
authors.lastname: Ireland
mesh_terms: D000293:Adolescent; D000328:Adult; D000435:Alcoholic Intoxication / Q000453:epidemiology; D000552:Ambulances / Q000706:statistics & numerical data; D001291:Attitude of Health Personnel; D054869:Clinical Audit / Q000379:methods*; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D004636:Emergency Service, Hospital; D006801:Humans; D010343:Patient Admission / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012606:Scotland; D016312:Treatment Refusal / Q000706:statistics & numerical data; D014754:Violence / Q000706:statistics & numerical data; D000078329:Workforce