Primary Survey
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Emergency department staff will often need to clinically assess an injured patient’s level of alcohol intoxication, but how well does such an assessment correlate with blood alcohol concentration? Cherpital and colleagues studied over 4000 patients across 12 countries and concluded that clinical assessment is moderately concordant with blood alcohol concentration, but concordance was lower among patients who had been drinking in the previous 6 hours. They ascribe this to a tendency for clinicians to diagnose intoxication in any patient who had been drinking.
See p 689
When someone dies suddenly we are often asked what the likely cause of death was. Mushtaq and co-workers present data suggesting that this judgement should be made with caution. In a series of 63 patients who died suddenly and subsequently underwent post-mortem examination, the cause of death identified by the most senior clinician was inaccurate in 40%. Pulmonary thromboembolism in particular was both over-identified
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