Saturday night and Sunday morning

Last night I spent from 23.00 to 01.30 in the A&E Department of a major London hospital, call it St Matthew’s, to see the effect of drinking on their caseload. Sister M, who was in charge of the shift, told me I should have been there the previous night, when firms were having their Christmas parties and the staff had been run off their feet.

But all agreed that UCH and St Thomas’s were far the most pressured by alcohol related admissions

Among those I saw in the ‘Majors’ section of the Department were: a man who, when his wife had left him, started drinking heavily and then began smashing up everything in his house until restrained by relatives or neighbours; another man who had crashed his motorised scooter after drinking 6 pints of lager, and a young woman brought in at 00.25 by the London Ambulance almost unconscious. As she was manhandled onto a mattress on the floor, having fallen out of a wheel chair, all she could say was ‘Oh, fuck, fuck off’. The woman had puked all over the ambulance and it took the attendants half an hour to clean it up.

Dr M said the man who crashed his scooter seemed like a nice guy, who didn’t normally drink. He didn’t think the police had breathalysed him, and the A&E Department didn’t normally test for blood alcohol because it would cost money, without affecting the subsequent treatment.

The ambulance staff told me that drunks were generally abusive, if they could speak at all, or their friends were. In the old days drunks with no signs of physical injury had been taken to police stations where they recovered overnight, but this was no longer the practice because there had been a few cases of people with serious injuries requiring treatment, being treated as plain drunks. So now everyone who gets paralytic and collapses in the street has to be taken into an A&E Department, even if 95% of them didn’t need treatment. The London Ambulance have a 6-8 seat bus called November375 which goes round central London picking up unconscious or semi-conscious people off the streets and dumping them in St Thomas’s or UCH..

At 01.30 another young woman was brought in from a night club, where she had fallen over drunk and had a suspected broken ankle. The A&E Department has its own dedicated x-ray facility which is open 24 hours a day.

St Matthew’s doesn’t routinely use Alcohol Use Disorders Identification Test (AUDIT) or, other questionnaires to screen A&E Department admissions for harmful or hazardous drinking, and as far as could be ascertained from this visit, haven’t been asked to participate in the proposed pilots