Screening Tools
Screening tools for use in the ED include:
AUDIT-C (Alcohol Use Disorders Identification Test – Consumption) – This is the recommended first-line screening tool in UK emergency care. It comprises three questions about frequency of drinking, quantity consumed on a typical day, and frequency of heavy drinking (≥ 6 units per occasion).
A score of ≥ 5 in men or ≥ 4 in women indicates hazardous drinking requiring intervention.
FAST (Fast Alcohol Screening Test) – is a four-item screening tool derived from AUDIT, useful for rapid ED assessment. A score of ≥ 3 indicates hazardous drinking. [8]
The Paddington Alcohol Test (PAT) – Specifically designed for ED settings to identify hazardous drinkers presenting with alcohol-related injuries or conditions. [9]
CAGE questionnaire – While historically used, this is less sensitive than AUDIT-C for detecting hazardous drinking and is better suited to identifying alcohol dependence rather than risky consumption patterns.
The CAGE questionnaire is a useful screening tool.
| C Have you ever felt the need to cut down your drinking? |
| A Have you ever felt annoyed by criticism of your drinking? |
| G Have you ever felt guilty about your drinking? |
| E Have you ever taken a drink (eye opener) first thing in the morning? |
‘Yes’ to two or more of the above suggests alcohol excess.
Learning Bites
- Screening questionnaire tools should be used to identify drinking issues in ED.
- AUDIT-C is the recommended first-line tool, with FAST and PAT as alternatives depending on clinical context.