Photo of Dr. Jason London
Trauma surgeon Jason London is leading the effort at UC Davis Health System to make brief interventions a standard of care in order to reduce repeat admissions because of alcohol-related injuries.

If one word describes the work of a trauma or emergency medical professional, it is intervention.

By calling on research, practice, knowledge and talent, medical caregivers insert themselves and their skills during the critical interval between trauma and death. Their intervention can restore life to the dying and function to the injured. The act of intervening also provides great professional satisfaction.

"The thrill of being able to dramatically intervene in the face of a devastating injury is a truly indescribable experience," says UC Davis trauma surgery professor David Wisner. "To know that you used your brain and hands to literally save a life is a magnificent thing."

The impact of intervention on alcoholism can also be significant, and a new UC Davis study aims to reduce the life-threatening risks of alcohol abuse.

"We are actively investigating whether or not we can modify dangerous drinking behavior using the stimulus of an injury to get the patient's attention and induce lasting change," Wisner explains.

Intervention for prevention

From drunken driving to domestic assault, alcohol consumption is a repeat offender that frustrates trauma and emergency-care professionals for a simple reason: It is wholly preventable.

"A surprise is the amount of alcohol involved in traffic-related trauma, and trauma in general, without regard to ethnicity or culture," explains Roxanne Woods, who coordinates the UC Davis Trauma Center's trauma prevention program. "The number of trauma cases related to drinking alcohol is very high."

Reducing recurrences

As the first regional recipients of California Office of Traffic Safety funds to study trauma patients with positive blood alcohol, Woods and UC Davis trauma surgeon Jason London will be documenting the effects of short interventions on future trauma admissions.

"The benefit is that the intervention assists the patient in realizing the risk of drinking," Woods says. "We want the patient to think about drinking, his or her hospitalization, the cost of loss of work, cost of care and the emotional cost to the family."

Referred to as a "BI" or brief intervention, 30-minute interview sessions between a trained professional and a patient with high blood-alcohol level has been shown to reduce trauma re-admissions, alcohol-related injuries and DUI arrests, explains London, an assistant professor of trauma and emergency surgery.

"The injury itself creates a situation in which the patient may be more amenable to change, what we call a 'teachable moment'," said London.

Because time and personnel are always in short supply, London wants to alter the current interview protocol. In many trauma centers, he notes, finding professionals with alcohol-intervention expertise may be next to impossible. Add to that the issue of time.

"Previous studies were done with trained psychologists who spent a fair amount of time with each patient," London says. "We are looking at whether trauma nurse practitioners trained by a professional psychologist who specializes in these interviews can obtain the same results with a shorter interview." His study is evaluating the benefits of reducing the intervention to about 10 minutes.

New standard of care

Making brief interventions a "standard of care" at UC Davis may become a near-term goal, Woods says, if the value of these minimedical consults become clear.

In the longer term, London says his finding could have a significant impact on how Level 1 trauma centers across the country operate.

"The American College of Surgeons is mandating that Level 1 centers conduct brief interventions," London said. "This study may provide us with an effective option, for both patients and trauma teams in reducing repeat alcohol-related injuries."