Retrospective analysis of alcohol testing in trauma team activation patients at a Canadian tertiary trauma centre

BMJ Open. 2018 Nov 13;8(11):e024190. doi: 10.1136/bmjopen-2018-024190.


Objectives: Although alcohol screening is an essential requirement of level I trauma centre accreditation, actual rates of compliance with mandatory alcohol testing in trauma patients are seldom reported. Our objective was to determine the prevalence of blood alcohol concentration (BAC) testing in patients requiring trauma team activation (TTA) for whom blood alcohol testing was mandatory, and to elucidate patient-level, injury-level and system-level factors associated with BAC testing.

Design: Retrospective cohort study.

Setting: Tertiary trauma centre in Halifax, Canada.

Participants: 2306 trauma patients who required activation of the trauma team.

Primary outcome measure: The primary outcome was the rate of BAC testing among TTA patients. Trends in BAC testing over time and across patient and injury characteristics were described. Multivariable logistic regression examined patient-level, injury-level and system-level factors associated with testing.

Results: Overall, 61% of TTA patients received BAC testing despite existence of a mandatory testing protocol. Rates of BAC testing rose steadily over the study period from 33% in 2000 to 85% in 2010. Testing varied considerably across patient-level, injury-level and system-level characteristics. Key factors associated with testing were male gender, younger age, lower Injury Severity Score, scene Glasgow Coma Scale score <9, direct transport to hospital and presentation between midnight and 09:00 hours, or on the weekend.

Conclusions: At this tertiary trauma centre with a policy of empirical alcohol testing for TTA patients, BAC testing rates varied significantly over the 11-year study period and distinct factors were associated with alcohol testing in TTA patients.

Keywords: alcohol testing; trauma management.

Publication types

  • Observational Study

MeSH terms

  • Accidents, Traffic / statistics & numerical data
  • Adult
  • Aged
  • Alcoholic Intoxication / blood
  • Alcoholic Intoxication / diagnosis*
  • Blood Alcohol Content*
  • Cohort Studies
  • Female
  • Guideline Adherence / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • Nova Scotia
  • Patient Care Team / statistics & numerical data
  • Registries
  • Retrospective Studies
  • Substance Abuse Detection / statistics & numerical data*
  • Tertiary Care Centers / statistics & numerical data*
  • Trauma Centers / statistics & numerical data*
  • Wounds and Injuries / blood
  • Wounds and Injuries / diagnosis


  • Blood Alcohol Content