UPD, not EMTs, call shots for alcohol transports

The power to send intoxicated students to the hospital rests with emergency responders at other colleges – not campus police, as is the case at GW, according to a Hatchet analysis.

University Police officers, who are certified in first aid and CPR, make the final call to send students to GW Hospital after field sobriety tests and Breathalyzer exams. At other schools with EMS units, only emergency responders make medical judgments.

“We call EMeRG in when we determine that we think they’re bad enough to go to the hospital, because we’re worried about their health,” UPD Chief Kevin Hay said. “Our goal is to make sure that no one dies from drinking 15 shots of vodka. That’s what we’re out to prevent.”

Last year, 75 percent of alcohol-related transports at GW resulted from UPD officers or house staff members stopping intoxicated students.

About a third of EMeRG’s about 900 on-campus calls listed alcohol as the primary cause last year. That rate that has dropped since 2010, when 36 percent of calls were due to intoxicated individuals on campus.

And while EMeRG is on site as officers make the final decision, the group’s coordinator said UPD officers override crew members – who are licensed District EMTs with months of training in at least basic life support – to enforce the University’s alcohol policies.

“EMeRG providers do not influence the officers’ decision to require someone to be transported to the hospital for intoxication,” EMeRG coordinator Stephen Gerber said.

But Michael Hilton, director-at-large of the National Collegiate Emergency Medical Services Foundation, said police should not make decisions about whether patients should be sent to the hospital. Volunteers in EMeRG, part of the national organization, act on behalf of the District’s medical director like other certified EMTs.

“In terms of a purely medical decision, if you don’t have the medical training, it doesn’t make sense to be making medical decisions about patients in the field,” Hilton, an EMS physician, said. “It’s probably not a best practice for a police officer to make that determination.”

UPD officers check students’ blood alcohol content twice through breath tests, but do not exclusively rely on that measure, though Hay said it is key in the decision to send an individual to the hospital.

“That’s going to be a big red flag for me because we don’t know where it’s going to top out,” Hay said, adding that his officers consider the “totality of circumstances.”

He said that under D.C. code, UPD officers handle intoxication as a public health problem, rather than a criminal offense.

Hay said that the department uses field sobriety tests, breath tests and horizontal gaze nystagmus tests, which involve moving an object horizontally in front of the person’s face. The latter test, according to the National Highway and Safety Administration, is accurate in 77 percent of cases.

“EMeRG relies on the officers’ assessment of when someone is too intoxicated to care for themselves,” Hay said. “The officer is determining whether or not the patient can provide consent for treatment.”

Rochester Institute of Technology and Georgetown, Penn State, Syracuse and Tulane universities have emergency response teams similar to EMeRG. At each school,

EMT medics determine whether a subject is in need of hospital care after coordinating with doctors via radio or phone. The schools’ rate of alcohol-related emergency calls are about 30 percent, similar to the GW rate.

Patients can only refuse transportation if EMTs determine that they are sufficiently alert, cognizant and display no signs of significant intoxication – even if they’re underage, Tulane’s EMS director Bijan Rizi said.

“Officers have no input in whether a person is transported,” Rizi said. “They’re not allowed to make any medical decisions.”

Georgetown’s Emergency Response Medical Service, known as GERMS, maintains a low threshold for advising hospitalization and urges patients to seek further medical assessment.

One sophomore, who spoke on the condition of anonymity because he is underage, said UPD officers dispatched EMeRG to transport him to the hospital after a Breathalyzer exam revealed a 0.14 percent blood alcohol content.

He passed a field sobriety test but was still transported to GW Hospital, where doctors gave him a cup of grape juice.

The University’s “good samaritan” policy grants disciplinary amnesty to students who seek out emergency care for friends even if they are underage and have been drinking.

More students have taken advantage of the policy over the last three years, with the number of calls rising to 33 percent of alcohol-related transports from 22 percent.

In 2009, sophomore Laura Treanor died from alcohol poisoning, prompting the University to launch a review of alcohol policies and better inform students how to recognize when their friends are dangerously intoxicated.

Raw EMeRG data doesn’t show the full picture of liquor-linked incidents at GW. About a third of calls were tallied as alcohol-related over the last three years, but other incidents in which students are unconscious and intoxicated are logged as “unconscious person” and not under the “alcohol” category, University spokeswoman Michelle Sherrard said.

And while more than three-quarters of EMeRG patients were transported to a hospital over the last two years, the service does not track the number of intoxicated students taken to the emergency room for care, as it does not document category-specific outcomes, Sherrard said.

A student scribe in GW Hospital’s emergency department said doctors and nurses have expressed frustration with the University’s alcohol transport policies. As a scribe, she sees most patients as they enter and exit the ER for treatment, and she works alongside medical practitioners. She asked to remain anonymous because she is not authorized to speak to the media.

“When someone is really very drunk and needs acute care, then obviously that’s not a source of frustration,” she said. “But when kids come in and they’re mostly fine, except that they’re just a little bit drunk, it is frustrating to some of the providers.”

GW Hospital spokesman Steve Taubenkibel declined to comment on alcohol-related admissions, costs and care in the ER.

The scribe recalled instances involving underage patients with very low blood alcohol contents, such as the case of one freshman who she said UPD officers sent to the hospital with a BAC of 0.02 percent.

Intoxicated patients who do not need serious medical attention, like stomach-pumping or an IV fluid, are monitored by nurses and physicians, handed a cup of water or juice and asked to sit on a bed for a couple of hours, she said.

Angelo Salvucci, an emergency room physician in Santa Barbara who serves as medical director at two county EMS services in California, said hospitalizing intoxicated individuals opens up the opportunity to refer them to counseling services, if needed.

“If they’re drunk to the point where EMS is called on their behalf, then that’s an early sign of a substance abuse problem,” Salvucci said.

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