Screening Adolescent Trauma Patients for Substance Use at 10 Pediatric Trauma Centers.
Michael J Mello, Sara J Becker, Anthony Spirito and 14 others
PMID 33156244WHAT IT FOUND
Only 159 of 300 adolescent trauma patients had documented substance use screening.
The CRAFFT found positive use in patients with negative blood or urine tests, so nurses should not rely on lab screens alone.
Key findings
01In 300 adolescent trauma records, 159 had any documented AOD screening.
02Only 19 of 159 screened patients had comprehensive screening with BAC, UDS, and a validated questionnaire.
03The CRAFFT identified positive marijuana use in six patients with negative UDS and positive alcohol use in three patients with negative BAC.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was nested within a larger implementation trial and was not designed to reliably detect differences by patient characteristics or between centers. It could only report what was written in the electronic health record, so actual screening may have happened but not been documented. The centers were invited to the parent trial, so they may not represent all pediatric trauma centers. Only 30 records were reviewed at each center, and the sampling took the first admitted adolescent on selected dates, which may miss other patients.
Declared interests
The authors declared no conflicts of interest.
The easy way to misread this
Do not assume negative blood alcohol or urine drug screens mean an adolescent has no substance use. The CRAFFT found marijuana use in six patients with negative urine drug screens and alcohol use in three patients with negative blood alcohol levels.