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- Title
Screening major trauma patients for prevalence of illicit drugs.
- Authors
Knott, Jonathan; Yap, Celene; Mitra, Biswadev; Gerdtz, Marie; Daniel, Catherine; Braitberg, George
- 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.
- Subjects
VICTORIA; DRUGS of abuse; SALIVA analysis; POINT-of-care testing; MOTOR vehicles; AUTOMOBILE driver education
- Publication
Drug & Alcohol Review, 2022, Vol 41, Issue 1, p285
- ISSN
0959-5236
- Publication type
Article
- DOI
10.1111/dar.13355