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The Injury Prevention Center at Rhode Island HospitalScreening, Brief Intervention and Referral to Treatment (SBIRT)Alcohol Screening
A recent survey of members of the Society of Trauma Nurses (STN) and the National Association of Children’s Hospitals (NACHRI), only 18% of hospitals screened all injured adolescents seen in the emergency department, while 26% screened injured patients admitted to trauma service [34]. Trauma centers are more likely to measure blood alcohol concentration than to use a formal screening instrument [35]. Blood alcohol concentration only detects current intoxication while screening instruments enable providers to get a clearer picture of patient alcohol use and identify any problem behaviors. Thus they have complimentary roles and the use of questionnaires is needed to detect more adolescents at risk for future injury.
Some screening tools only take one to three minutes to complete and can be administered by a range of staff, self administered or administration aided by technology (laptop/PDA). It is important for trauma center to determine who is best suited to administer the screening instrument and how this responsibility can be embedded into that individual(s) daily tasks to assure compliance. Similarly, it is equally important for institutions to determine where during the patient’s admission the alcohol screening will occur. There is limited research about what the age range in which trauma centers should conduct alcohol screening. Some points to consider: Older adolescents account for the majority of trauma center alcohol related diagnoses. In Chung et al 2000, 16 to 19 years accounted for 78% of teens with alcohol diagnosis (in a sample of 13-19). Focusing on younger adolescents could possibly help to prevent or delay initiation of alcohol use. Early onset of alcohol use in adolescence increases the risk of problems later in life due to alcohol misuse. This is concerning in that if you relate back to the material presented earlier some very young adolescents use alcohol.
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Alcohol screening is asking a patient a series of questions to learn more about their alcohol use. Screening is quick, simple way to identify patients who need further assessment or treatment for substance use disorders. It does not establish definitive information about diagnosis. The goal of a SBIRT program is to make screening for substance abuse a routine part of medical care. 
Critical Decision Points: Who should conduct alcohol screening? When should alcohol screening occur?
