Commentary: Impaired driving: what is your responsibility as an emergency physician?

You are driving home from a busy shift when you glance over at the driver next to you as she swerves out of her lane. Your heart sinks when you recognize her as the woman you just discharged. She came in toward the end of your shift with her "typical migraine" and told you that the last time she was in the emergency department (ED), she was administered a combination of medications that helped. You gave her a "migraine cocktail" of Compazine, Benadryl, and Toradol, and she was feeling better when you checked on her; thus, you told her she could go home. You assumed that she had a ride home; apparently, that was a poor assumption. How many of the patients whom you release would you want driving on the highway next to you? Think about the medications you commonly prescribe: Benadryl, Phenergan, Ativan, and Vicodin. Do you tell all of your patients that the medication you are giving them may affect the way they drive? Except for aspirin, Zofran, and antibiotics, the majority of the medications that are administered in the ED have properties that could impair driving; they are referred to as cocktails for a reason. The research and public health communications related to impaired driving have primarily focused on alcohol and illicit drugs. It is clear that driving impairment begins when the blood alcohol level passes 0.05 and that higher levels cause greater impairment. (Author/publisher) Commentary on Schroeder E. Impaired driving: what is your responsibility as an emergency physician? Ann Emerg Med. 2012; 59:324-326.