A WEEK of mixed reaction to its proposal that 'drunk tanks' be used in hospital A&E wards to deal with intoxicated patients has not watered down Fine Gael's enthusiasm for the controversial measure.
The party's health spokesman Dr Liam Twomey this weekend said 'drunk tanks' had been used in Irish A&E wards in the past and there was no reason why they shouldn't make a comeback.
"When I worked in the old Meath Hospital in Dublin, we used to have a wet room, " Twomey told the Sunday Tribune. "It was a room with five blue plastic mattresses in individual cubicles supervised by a nurse and security that allowed drunk people sleep off their drink."
With drunk tanks currently being used in countries such as Finland and the Czech Republic - with varying degrees of success - Fine Gael believes the same approach here could alleviate A&E chaos caused by binge drinking. "There has been an argument made that if drunk people are left in a wet room to sleep drink off that they could choke on their own vomit, " said Twomey. "If somebody comes into an A&E ward, they will be supervised. No patient in any hospital should be left unsupervised, especially if they are in A&E. We do reccognise that all patients coming into A&E with alcohol-related complaints are not the same.
Some of them have to be fully medically managed and many of them need to be X-rayed."
Irish A&E consultants have voiced differing views on the 'drunk tank'/ 'wet room' proposals. Consultants at St Luke's Hospital in Kilkenny have already taken action to combat the general chaos that has become synonymous with A&E wards across the country, streamlining their wards so patients admitted to A&E are separated into different wards on arrival. Dr Gary Courtney, who works in the A&E unit there, said: "I presume that if serious injury has been excluded and the patients are just drunk that these wet rooms are a good idea. These people would have to be supervised in the wet room and taken in for further medical attention if their condition deteriorates."
He added, "The wet rooms will have resource implications as hospitals will need to provide an area to look after them and a nurse to watch over them."
But at Dublin's Mater Hospital, Dr Peter O'Connor, one of the consultants on the A&E ward, vehemently opposes Fine Gael's plan. "This idea might work for a while until some unfortunate patient comes in with a head injury or is diabetic and then dies, " he said.
"It is quite possible that you could get a patient coming in to A&E with a combination of these factors at any time.
Unless you have very good supervisory arrangements, then there is a risk that somebody could roll over on their back and end up choking on their own vomit. If one person dies, that is one too many and we should not take that risk."
The debate about the merits of drunk tanks is not unique to Ireland and a similar discussion has been taking place in Scotland over the last two years. Plans are currently in the offing in Edinburgh for the opening of a 'drunk tank' where dangerously intoxicated people can sober up.
The Edinburgh Action on Alcohol and Drugs Team, along with the Lothian and Borders Police and the Salvation Army are all involved.
The aim is that such a unit would take pressure off the police and hospitals which currently deal with such cases. It would be staffed by nurses who would counsel intoxicated arrivals on how to reduce their alcohol consumption. People picked up by police for being drunk and disorderly would still be examined by medics to ensure they did not need treatment before being taken to the unit.
In an interview with the Scotsman newspaper, David Steedman, a leading technician at Edinburgh Royal Infirmary's A&E department, said: "We would be very supportive of a safe environment for drunk individuals to recover in which they would not place an extra burden on emergency services."
Elsewhere in Europe, drunk tanks have been used in Prague since 1947, with a new drunk tank opened in the Czech capital as recently as 2004. Based at the Bulovka teaching hospital in Prague, this "anti-alcoholic station" boasts an intensive care unit among its facilities.
Most people in the Bulovka facility are allowed sleep off their alcohol intake, while people who act aggressively are taken into a room where they are tied to a bed until their alcohol level drops and are then put into a normal bed for the rest of the night.
Finland has the biggest 'drunk tank' in Europe and the police in Helsinki go around picking up drunkards off the streets before locking them in the 'drunk tank'. Lit up by bright fluorescent tubes, the small cells contain a foam mattress and a toilet and the drunkards are monitored by CCTV in case they fall ill.
Fine Gael's proposed measures for dealing with drunks in A&E wards consist of hospitals introducing wet rooms where drunks can sleep off the effects of drink after a medical assessment. They have also proposed increasing hospital security at weekends and introducing fines for patients who are found to be simply under the influence of alcohol and are not ill or injured.
Said Dr Liam Twomey:
"Why should hospitals need to be used as some sort of slopouts with drunk patients taking up beds to sleep and some of them wetting the bed?
There is a big difference between people who are disruptive and drunk in our A&E departments and those needing to be medically managed.
It's only when people have personal experience of an A&E waiting room and see drunk people being disruptive and urinating in bins that they realise the benefits of a wet room."
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