Abstract
Objective: To describe the scale and range of acute medical problems among patients who present to an inner city accident and emergency (A&E) department after attending nightclubs in Liverpool.
Methods: From April 1997 to April 1998, all patients identified as having attended a nightclub before their arrival at the department were included in the study. Information regarding their attendance was gathered retrospectively using a standard proforma.
Setting: A large, city centre, teaching hospital A&E department with an annual new patient attendance rate of over 95 000.
Result: 777 such patients were enrolled in the study (0.81% of all new attendances during the same period). This was probably an underestimate, as some eligible patients were not identified during the study. Predictably, most presentations were at the weekend between midnight and 08.00. Suprisingly, the commonest mode of transport to the hospital was an ambulance (38%, 298 of the total). Assault accounted for most presentations (57%, 443 of the total) and lacerations were the commonest injury (the face being most frequently affected). Alcohol was the commonest intoxicant overtly associated with the A&E department attendance.
Conclusions: Injury after assault is the commonest precipitant of hospital care among clubbers in Liverpool. Alcohol is the most important contributory factor, although illegal drug misuse is a considerable challenge in the clubs themselves. A number of measures such as (a) the introduction of unbreakable glass or plastic containers; (b) the elimination of glass from outside clubs; (c) the provision of high quality immediate medical care at larger venues; (d) the curbing of over crowding and cheap drinks promotions; (e) registration of doormen, and (f) targeted policing of the areas around nightclubs are urgently required to reduce the healthcare (and civic) burden of clubbing. The cost for these should be borne by the highly profitable clubbing and brewing industries. A national code of practice for clubs—already in existence voluntarily—should be made mandatory.
Full Text
The Full Text of this article is available as a PDF (92.1 KB).
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Ashton C. H., Kamali F. Personality, lifestyles, alcohol and drug consumption in a sample of British medical students. Med Educ. 1995 May;29(3):187–192. doi: 10.1111/j.1365-2923.1995.tb02828.x. [DOI] [PubMed] [Google Scholar]
- Bisson J. I., Shepherd J. P., Dhutia M. Psychological sequelae of facial trauma. J Trauma. 1997 Sep;43(3):496–500. doi: 10.1097/00005373-199709000-00018. [DOI] [PubMed] [Google Scholar]
- Brown E., Sindelar J. The emergent problem of ambulance misuse. Ann Emerg Med. 1993 Apr;22(4):646–650. doi: 10.1016/s0196-0644(05)81841-4. [DOI] [PubMed] [Google Scholar]
- Burdett-Smith P. Criminal injury compensation: from B to A. J Accid Emerg Med. 1999 Jan;16(1):43–47. doi: 10.1136/emj.16.1.43. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Collier D. J., Beales I. L. Drinking among medical students: a questionnaire survey. BMJ. 1989 Jul 1;299(6690):19–22. doi: 10.1136/bmj.299.6690.19. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Forsyth A. J. Places and patterns of drug use in the Scottish dance scene. Addiction. 1996 Apr;91(4):511–521. doi: 10.1046/j.1360-0443.1996.9145116.x. [DOI] [PubMed] [Google Scholar]
- Hocking M. A. Assaults in south east London. J R Soc Med. 1989 May;82(5):281–284. doi: 10.1177/014107688908200512. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Magennis P., Shepherd J., Hutchison I., Brown A. Trends in facial injury. BMJ. 1998 Jan 31;316(7128):325–326. doi: 10.1136/bmj.316.7128.325a. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Miller P. M., Plant M. Drinking, smoking, and illicit drug use among 15 and 16 year olds in the United Kingdom. BMJ. 1996 Aug 17;313(7054):394–397. doi: 10.1136/bmj.313.7054.394. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Shepherd J. P., Brickley M. R., Gallaghar D., Walker R. V. Risk of occupational glass injury in bar staff. Injury. 1994 May;25(4):219–220. doi: 10.1016/0020-1383(94)90064-7. [DOI] [PubMed] [Google Scholar]
- Shepherd J. P., Robinson L., Levers B. G. Roots of urban violence. Injury. 1990 May;21(3):139–141. doi: 10.1016/0020-1383(90)90081-5. [DOI] [PubMed] [Google Scholar]
- Shepherd J. Preventing injuries from bar glasses. BMJ. 1994 Apr 9;308(6934):932–933. doi: 10.1136/bmj.308.6934.932. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stockwell T., Lang E., Rydon P. High risk drinking settings: the association of serving and promotional practices with harmful drinking. Addiction. 1993 Nov;88(11):1519–1526. doi: 10.1111/j.1360-0443.1993.tb03137.x. [DOI] [PubMed] [Google Scholar]
- Webb E., Ashton C. H., Kelly P., Kamali F. Alcohol and drug use in UK university students. Lancet. 1996 Oct 5;348(9032):922–925. doi: 10.1016/s0140-6736(96)03410-1. [DOI] [PubMed] [Google Scholar]
- West R., Drummond C., Eames K. Alcohol consumption, problem drinking and anti-social behaviour in a sample of college students. Br J Addict. 1990 Apr;85(4):479–486. doi: 10.1111/j.1360-0443.1990.tb01668.x. [DOI] [PubMed] [Google Scholar]
- Williams H., Dratcu L., Taylor R., Roberts M., Oyefeso A. "Saturday night fever": ecstasy related problems in a London accident and emergency department. J Accid Emerg Med. 1998 Sep;15(5):322–326. doi: 10.1136/emj.15.5.322. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wright J. D., Pearl L. Knowledge and experience of young people regarding drug misuse, 1969-94. BMJ. 1995 Jan 7;310(6971):20–24. doi: 10.1136/bmj.310.6971.20. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yates D. W., Hadfield J. M., Peters K. Alcohol consumption of patients attending two accident and emergency departments in north-west England. J R Soc Med. 1987 Aug;80(8):486–489. doi: 10.1177/014107688708000810. [DOI] [PMC free article] [PubMed] [Google Scholar]
