No holiday from booze-induced harm
As most workplaces wound down for the holidays, the emergency department at Palmerston North Hospital was bracing for a bit of everything, writes Janine Rankin.
Festive celebrations are guaranteed to send a stream of damaged drunks to Palmerston North Hospital’s emergency department to be patched up.
Middle-aged fathers will turn up with broken ankles or wrists after falling off the trampoline, or coming to grief showing the kids how to ride a skateboard or scooter.
Boisterous conversations will turn nasty, breaking faces and hands.
People will fall over and squash children, and no-one quite knows how many children have accidents and hurt themselves while the tipsy adults aren’t paying attention.
Emergency department clinical director David Prisk said it was no holiday for hospital staff.
‘‘There is really not a summer any more,’’ he said.
There is little respite from the flow of patients with respiratory and other illnesses, there are likely to be more car crashes than ever, and more people drink more alcohol than they usually would and end up in a mess.
An Australasian College for Emergency Medicine spot check of New Zealand emergency departments at 2am on Sunday, December 16, found one in six patients were there for alcoholrelated reasons.
‘‘We see the effects of people driving drunk, assaulting each other drunk, sometimes coming in with really horrific injuries,’’ Prisk said.
The acute care team was devoted to patching them up, but sometimes that was not easy.
Prisk said it was not just the tendency towards being abusive or violent that made drunk patients a challenge.
The pain-killing power of alcohol and intoxicated patients’ lack of judgment brought on a reluctance to wait around, and a desire to go somewhere else.
‘‘Sometimes, they try to leave and we have to coax them to stay, when they clearly have an open ankle fracture.’’ Others stay away too long, choosing to sleep off their over-indulgence, and only realising they have a serious injury when sobered up. The delay can compound the injury and make treatment much more complex.
Acute care service manager Carrie Naylor-williams said some intoxicated patients wanted to be ‘‘helpful’’. But their misguided efforts could put themselves, staff and other patients at risk.
Sober patients often complained about the noise and fuss around those who were clearly drunk, but Naylor-williams said staff were dedicated to helping everyone.
Emergency department staff often had feedback from the wards later on about patients who were apologetic, embarrassed and grateful as they recovered.
‘‘For a number of them, they will never do it again. It’s a really hard lesson they learn.’’
This summer, staff working in the emergency department are looking forward to the benefits of an almost-completed makeover of the unit that will offer patients more privacy and dignity.
There is an improved, elevated reception area that puts check-in staff at eye-level for the walking wounded.
There will be new triage rooms where minor treatments can be managed without the patient needing to confront the resuscitation area.
And in behind are beds where patients can be assessed and undergo tests while waiting for
‘‘We see the effects of people driving drunk, assaulting each other drunk, sometimes coming in with really horrific injuries.’’ David Prisk, ED clinical director
admission or discharge, also away from the main trauma area.
The rest of the hospital is optimistically preparing for the traditional summer lull in admissions, winding down where it can to allow staff to take annual leave. But there is little that is predictable about emergency care, and staff must always be poised for an influx.