An initial seven-week-long survey conducted recently at Byron Bay Hospital has opened a window into the drinking habits of young people in Byron Bay - or at least those who seek medical attention at the Emergency Department.
At present, ED staff are not tasked to seek data on the possible links between presentations and alcohol consumption, and are generally too busy to take on a non-core activity.
However, some interesting trends were noted. For instance, 79 per cent of the presentations considered to be alcohol-associated were people between the ages of 18 and 25 years, with 75 per cent stating they lived in the Byron area. The gender breakdown was close to balanced – 52 per cent were male, 48 per cent female. The commonest triage presentations were in category 4, with none in the critical category 1.
While there seems little reason to doubt the accuracy of these figures, the number of recorded alcohol related presentations was so small ¬- only 5.7 per cent - that the finding may have little value.
As the ED in Byron is used as a GP service between 6.00 pm and 9.00 am, and frequently during the day, the number of true emergency-type presentations, including those that may be alcohol related, are proportionately fewer in this study.
Further study should be undertaken when resources permit, according to local GP Graham Truswell.
Dr Truswell, Chairman of the Byron medical staff council, told GPSpeak that, “We feel this study has been worthwhile, but due to numerous issues, the true extent of alcohol related presentations does not seem to have been captured.
“As all staff are concerned about the amount of binge drinking and violence, the hospital plans to improve on what we have done and repeat the study when possible.” That the hospital does not collect detailed information on alcohol is not unusual either locally, or in Australia at large.
There are various reasons for this, including clinical workloads, the practice of dealing with patients’ presenting issues not the causes, issues relating to patients’ unwillingness to discuss their behaviours, and the absence of a culture in ED departments to collect data for research. Anecdotal reports, however, from many hospital staff - and police - indicate the involvement of excessive alcohol in a range of trauma, including physical and sexual assaults, both in public and domestic settings, and motor vehicle accidents. The Byron study was conducted by University of Wollongong medical student Haddijatou Hughes, whose clinical placement is coordinated by the University Centre for Rural Health, North Coast.
A long-stay final year student, she has been living in the area and attending classes at Lismore Base Hospital and UCRH since mid-2013, also undertaking two days of GP placement a week at the Bangalow Medical Centre.
Dr Michael Douglas and Dr Hudson Birden provided assistance with the Byron Bay Hospital ED project. Ms Hughes found that around two-thirds of those presenting had been drinking most of their alcohol ‘at home’, which may have included rental premises, as the period spanned ‘Schoolies’. The main presentation age group was 18-year-olds, some 75 per cent of whom had consumed 10 drinks or more. Approximately 20 per cent of respondents said they had consumed energy drinks, and 50 per cent said they had drunk ‘shots’ of spirits.
Although ‘preloading’ before going to licensed venues was around 50 per cent, most ED presentations appeared to come from those who had been drinking ‘at home’, rather than in licensed premises. However, those presenting on the day following an alcohol related event, or who presented appearing sober, often did not get asked about their recent drinking history.
The Last Drinks campaign, which continues to be deeply concerned about alcohol related violence and general harm, including public safety and the reputation of Byron Bay, hopes that the study can be repeated, and extended. A comparison between the town’s quieter and busier periods is one aspect worth exploring, Dr Truswell said.
It is also hoped that a relatively minor adjustment to the computerised triage and record system would facilitate the collection of data without creating an impost on ED clinicians.