Alcohol abuse strains emergency centres

2019-05-07 06:00

Injuries related to alcohol abuse play a dominant role in the province and is an increasing societal problem which is impacting and placing strain on the Western Cape Government Health Emergency centres in the Cape Town Metropole.

“Alcohol-related presentations to emergency units affect service delivery in two large categories which we identify as trauma-related injuries from motor vehicle accidents, interpersonal violence and abuse. The second category is medical chronic conditions linked to long term alcohol abuse, which causes diabetes, chronic pancreatic complications and cardiac disease,” says Dr Phillip Cloete, emergency medical specialist and head of the Emergency Centre at Victoria Hospital.

“We tend to see an increase in alcohol-related incidents over weekends, especially end of the month (post-pay-day) weekends as well as public holidays, Christmas and New year periods,” says Cloete.

Emergency Centres across the metro do not have additional staff to deal with the increase in the load of alcohol-induced trauma cases.

The treatment and medical management of these cases impacts on other emergency cases which in turn contributes towards longer waiting times and impacts other support staff including security, as patients under the influence may be aggressive and uninhibited which could be traumatic for other patients and staff.

“An example of the strain alcohol-induced patients has on emergency units, is if a patient sustains poly-trauma (multiple severe injuries) such as gunshot wounds to the chest and abdomen and presents in a critical condition, this resuscitation will require multiple staff members including doctors, nurses and support staff and it could take several hours to stabilise such a patient depending on the specific injuries and further management.

“This will impact other stabilised patients waiting for treatment, which in turn prolongs waiting times,” says Cloete.Pressure on services

“Western Cape Government Health Facilities deal with way more than what they are designed for. Service pressures are experienced across facilities, and we see quite a number of cases fuelled by irresponsible alcohol use.

“This is a call to the public to consider these facts, especially how the personal choice to consume alcohol irresponsibly, not only impacts the individual, but robs other patients of much needed medical attention.

“To curb this immense and unnecessary pressure we experience on our available services, we need communities to work with government to ensure we keep the unnecessary levels of trauma and violent injuries through irresponsible substance use to a minimum,” says provincial minister of health Nomafrench Mbombo.

Victoria Hospital’s Emergency Centre treats quite a few homeless patients who have sustained injuries from violent related injuries sustained from the effects of alcohol abuse.

The health and social impact of alcohol can be multidisciplinary, as patients require long-term admission placing added strain on bed capacity and may develop withdrawal symptoms from alcohol.

They may also require social worker involvement and placement for care as a long-term solution.

Between December last year and January, the Emergency Medical Services transported over 30 000 emergency cases to hospitals.

Of these cases, 23% (8 069) were a result of patients sustaining injuries, which range from violent trauma such as stabbings and gunshots to physical and interpersonal violence as well as accidental injury.

From the 8 069 cases, the top three causes were:

. Assault with a weapon: 2 894 cases were seen where people were assaulted with a weapon – which includes all types of weapons and is not limited to a knife or gun;

. Physical assault: 956 cases;

. Accidental injury: 864 cases (presumed unintentional) were taken to hospital by ambulances.

Injuries and interpersonal violence are one of the biggest contributors to the province’s quadruple burden of disease.

While the Department of Health feels the effects of violence and injuries, addressing the upstream factors must be a collaborative effort by all departments where they look at taking a Whole of Society Approach (WOSA) to tackle the challenge of alcohol abuse.

Residents are urged to be more responsible concerning their well-being, as excessive alcohol use could place their lives in danger and have a long-term effect on their health status.

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