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University Health Services Clarifies Processes At St. Elizabeth’s Hospital

St. Elizabeth’s Medical Center in Brighton is often the destination for Boston College students in need of a medical transport following an alcohol-related incident.

According to Thomas Nary, M.D., director of University Health Services (UHS), upon arriving at St. Elizabeth’s or another hospital, students should only anticipate a routine evaluation by emergency room physicians.

“The only thing that anybody should expect is an evaluation—a medical evaluation and judgment,” Nary said.

Any actions that follow, Nary said, would depend on the specific situation, as the process in the emergency room is variable according to an individual’s state. Someone with a high blood alcohol content (BAC) would likely undergo further testing and perhaps be given an IV, while someone else who only appears drowsy and is beginning to sober up will be observed, likely kept for a few hours, and then sent home.

“They keep them a while because … they have to do decide two things: whether the person is on the way down, or they’re lightening up,” Nary said. “And the one other thing is an evaluation, and most of that is history, unless there is another drug on board.”

He specified that, hopefully, students would tell doctors if they had taken any drugs in combination with their alcohol consumption, and know that in providing that information to a medical professional, they would not be disciplined. The result of sharing this information would only be greater, more appropriate care provided to them. Any information shared in either a hospital or the UHS infirmary itself is confidential.

In cases where it is unknown whether drugs have been involved or students do not communicate any information regarding drugs, Nary said that certain symptoms are evaluated to determine whether further testing for other substances would be required.

“An automatic drug test would not be done without the student’s knowledge, and [then] probably only [if] the signs and symptoms warrant,” he said.

“For example, does the patient have an abnormally high heart rate? Are the pupils wider than expected? Is the patient flushed? Is he or she not ‘waking up’ or responding as expected?

“If someone does not look like they’re turning around, then they’re probably get blood tested to look for other substances.”

Nary said he does hear students express concern over a lack of action taken by St. Elizabeth’s when they have been transported to the emergency room for alcohol consumption and kept only for observation. In many cases, however, the hospital likely acted according to the standard process.

“That’s probably the right thing—they let you sleep it off,” Nary said. “They made their evaluation, and it doesn’t look like you’re in trouble—you’re not vomiting, you’re coming up, not going down, you don’t have any other things on board.

“Even if they don’t ‘do something,’ they protected you until it was apparent that you were okay to protect yourself.”

Nary emphasized that the process is not precise, and that there is a level of judgment involved by the emergency room physicians who are charged with sorting the incident out. Self-evaluation of one’s own state, he said, is difficult when one is intoxicated, and for that reason, they may keep individuals as a precaution.

St. Elizabeth’s did not respond when contacted to provide further clarification of the evaluative process in the emergency room.

Nary also said that there is only communication between the hospital and BC if a student is being transferred from the hospital back to the infirmary for further care or observation. It is good medical practice to discuss the circumstances of a transfer between the two medical facilities, Nary said, just as if a patient were being transferred between two major hospitals.

If a student is discharged from the hospital and returns home, UHS would, in most cases, not even know about the incident. BCPD would have a police record of the incident and transport, but it would have nothing to do with UHS unless BCPD transports a student back to campus after leaving the hospital. In this case, the police may bring the student to the infirmary for a final check-up to ensure they are all right to go home, but Nary said this stay could last only five minutes before a student is sent home.

Although the vast majority of students are transported to the emergency room at St. Elizabeth’s, the hospital and the University do not have any formal relationship or contract. St. Elizabeth’s is the closest hospital to the BC campus—approximately 1.5 miles away—followed by Newton-Wellesley Hospital in Newton, which is approximately five miles from campus. Nary said that, while students can be taken to Newton-Wellesley, the emergency room facilities at St. Elizabeth’s are significantly larger.

Featured Image courtesy of Mel Evans / AP Photo

November 3, 2014

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