Acute illness such as severe dyspnea, myocardial ischemia, or suspected stroke may render patients hazardous to drive. Nonetheless, many of these patients elect to drive themselves to the ED, placing themselves and others at risk of traumatic injury. This observational prospective study documented the frequency of this (to the author's knowledge) previously unstudied phenomenon. Consecutive patients seen in a military ED over a period of 28 days were asked about their means of transport to the ED. Charts were reviewed, categorized by primary complaint and disposition, and graded into one of three categories by risk of incapacitation (minimal risk, substantial risk, and definitely dangerous). Exclusion criteria included age <16, transport from another medical facility, and unavailable transportation information. 3,130 patients were seen during the study time period. 1,199 patients were excluded (1,043 by age, 89 due to transport from another facility, and 147 due to lack of transport information). 1,851 patients were enrolled. 20 of 108 (18.5%) patients considered definitely dangerous chose to drive. 152 of 536 (28.4%) patients at substantial risk drove, and 507 of 1,207 (42.0%) patients with minimal risk drove. 14 of 60 (23.3%) patients admitted to monitored beds drove. 8 of 48 (16.7%) patients with ischemic-type chest pain, severe dyspnea, or neurologic complaints consistent with stroke drove. It is concluded that patients whose acute medical condition renders them hazardous to drive commonly choose to drive themselves to the ED. A public education campaign is needed to discourage this dangerous practice. (Author/publisher)
Abstract