"Extremely Intoxicated" sign-off

My pager went off the other morning sometime after 0200 – “Extremely intoxicated 20 y/o called in by campus safety”.

When I got down to the station the crew included our chief (who was driving) and two students I know well (both EMTs). In the absence of a medic, the EMT on the board is usually “crew chief”, and in this case she asked me if I wanted to run the call. I said “sure”.

Being new at this it was harder for me than I thought. I was a little torn regarding what to do with the patient and not 100% comfortable with the decision. When we arrived she was standing talking with campus safety (who, in this case, are also local police). She was alert and oriented to time, place and self. CMSx4, PEARL, HEENT clear. Smooth pursuit eye-movements were fine. Seemingly nothing wrong with her (though she did smell of EtOH). Her chief complaint was that she was embarrassed and wanted to go home. She also wondered if this would end up on her “permanent record”. Our chief told us “check her out and sign her off”.

The problem, from my perspective, was that this young lady was found on the ground under some bushes. Since I didn’t find her, it is hard to say whether she was sleeping or had some sort of loss of consciousness from another cause. If it had been my call with no other input I would have taken her to the hospital to get checked out. My chief made it clear, however, that we should let her go, and that if we took her to the ED we’d catch hell given she was walking, talking and seemingly fine. Given campus safety was going to transport her and make sure someone was there to watch over her, it wasn’t like we were letting her walk off into the night, but I still felt strange about it as there was a small but non-zero chance there was something else going on with her.

From my chiefs perspective she was a “safe bet”. That is, the odds were high she’d be fine. I guess I just need to learn that it is ok to “bet” on these things, as my gut reaction is still “better safe than sorry”. Of course, our local ED would be overrun if we brought in every college student who had a few beers, so some balance needs to be struck. I need to learn how to strike that balance and feel ok about it.