Authors (including presenting author) :
Suen HN(1), Wong MH(1), Cheung SL(1), Cheung CL(1), Tse CY(1)
Affiliation :
(1)Department of Psychiatry, Tai Po Hospital
Keyword 2: :
Alcohol Withdrawal
Keyword 3: :
Blood Alcohol Concentration
Keyword 4: :
Point-of-Care Testing
Keyword 5: :
Fall Prevention
Keyword 6: :
Early Screening
Introduction :
Alcohol consumption poses risks of intoxication, withdrawal, and falls. In 2024, 16% of male psychiatric patients at Tai Po Hospital showed alcohol use, highlighting the need for safety measures. Funded by the Quality-of-Care Program, a Point-of-Care Testing (POCT) Alcohol Analyzer was implemented in December 2024, which is the first-ever mode of utilization across hospitals, to measure blood alcohol concentration (BAC) via exhaled breath for early detection and management in psychiatric admissions.
Objectives :
•Early detection of acute alcohol intoxication
•Early prediction of the severity of alcohol withdrawal
•Early identification of patients' alcohol induced fall risks
•Enhancement of staff awareness and monitoring of alcohol management practices
Methodology :
The analyzer screens patients' BAC levels upon admission, targeting those with alcohol-related disorders or suspected use. Evidence-based BAC thresholds (0.12% and 0.3%), established through literature review, identify risks of intoxication, withdrawal severity, and falls. With medical officers supported to oversee results interpretation, the implementation aims for early detection of acute intoxication, prediction of withdrawal severity, identification of fall risks, and enhanced staff awareness and monitoring of alcohol management practices. Association of BAC and withdrawal will be analyzed using odds ratio.
Result & Outcome :
From December 2024 to December 2025, 12.1% of new admissions at both male and female acute admission wards (n=301, N=2497) were screened, with 27.2% (n=82) showing positive BAC. Among patients with 0.01-0.29% BAC, 19.5% developed moderate-to-severe withdrawal symptoms, with 8.57 odds compared to patients with no BAC (p< 0.001). Notably, 50% with 0.12-0.29% BAC developed severe withdrawal, with 18.07 odds compared to those with BAC < 0.12% (p< 0.001). All with 0.12-0.29% BAC were classified as high fall risk, with no alcohol-related falls found during inpatient stays. Two high-BAC cases (0.19% and 0.26%) required emergency treatment for alcohol-induced complications following close monitoring. It demonstrates the effectiveness of BAC screening in detecting intoxication and predicting withdrawal, preventing severe complications, strengthening the fall preventive measures, and enhancing staff awareness of alcohol detection and management. Besides, 95% of staff (n=33; N=35) agreed that the analyzer facilitates early detection instead of waiting for results on blood ethanol levels, serving as a quick reference for interventions. This nurse-led practice enhances psychiatric care through technology-driven alcohol screening, enabling tailored interventions, focused monitoring, and proactive fall prevention. It demonstrates potential for broader adoption across psychiatric and general healthcare settings, improving alcohol-related risk management through evidence-based practice to uphold patient safety.
