ETOH and OD Census

I just been working in the adult ER for a few weeks. I work in a bad area of town and we see lots of OD and ETOH abuse. The ED is 16 beds and we will have 4-6 tied up a nightly for OD and drunks. I am curious how many do you typically see a night, how many beds do you have? Do you find this a typical census in the ER.[/quote']

Yup, and we are a college town so there are certain times of the year when it's much higher. :)

We see ODs daily ... about half heroin and half all others combined. Daily ETOHers ... considerably more during major city events and holidays.

We have our regular ETOH'ers who we see daily, sometimes 2-3 times a day. I work weekend nights so we see an increase on Saturday night after 2AM when the bars close.

Lately, we have been seeing an increase in K2 users.

Fortunately we have three EDs in the area, and most of the college age ODers go elsewhere. Occasionally we'll get a professional ETOHer, but typically they're known at our other ED, so we don't even bother with the banana bag, etc. Just check them for anything immediately life threatening and give them a bus token away. AWAY!!!!!

Typically we'll only get the serious ones that need to be in the ICU.

I had a heroin od tell me there's a dealer around the corner they all love, and sometimes they shoot up in the parking lot in the event they od.

We have an "MMU" (Medical Management Unit) or in other words "drunk tank" - they all get their clothes and belongings bagged and locked up in the dirty utility room, special yellow gowns put on them (that signal the patient has altered mental status) and we just run fluids through them and have a PCT watch over them until they sober up (assuming there are no respiratory or other issues going on). Some of them require restraints and anti-anxiety medication, some require isolation if they have lice, etc. It's a rough scene, but yes, the hospital I worked at over the summer (and will hopefully get a job at) is in a rough part of town and ETOH and ODs are pretty commonplace. I would say during a 12 hours shift I'd see about 10 ETOH and 3 OD patients in the unit.

I remember one instance, a young kid came in drug seeking and walked out AMA when he wasn't given anything but Toradol for his "excruciating back pain." Sure enough, 2 hours later and he came in via EMS - he had scored some heroin and was found wandering and falling over in traffic. Kid had to have been 6'5" and 135lbs, and I believe he was 19 - had to eventually be given Narcan. Very sad, but it happens.

We probably tie up 10% of our beds per night on drunks and tweakers, with a few PCP, narcs, and bath salts tossed in on occasion... the vast majority are drunks or tweakers, though.

Lately, we have been seeing an increase in K2 users.