Are emergency department staffs' perceptions about the inappropriate use of ambulances, alcohol intoxication, verbal abuse and violence accurate?
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.
Vardy
J
J
Department of Emergency Medicine, Hairmyres Hospital, East Kilbride, UK. jenvardy@doctors.net.uk
Mansbridge
C
C
Ireland
A
A
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