Alcohol intoxication at AFL game

Patient Information

Dispatch: A 21YO male has been brought to the FAP by security after being found sitting on the concourse at Optus Stadium, unsteady on his feet and smelling strongly of alcohol. (Darren Kowalski)
Patient: Darren Kowalski — 21yr (80kg)
Incident History: Pt was found by stadium security sitting on the ground near Gate 4 during the third quarter. Security report he was slurring his words and unable to walk without assistance. No witnessed falls or head strikes reported.
Emergency Contact: Kelly Kowalski (Wife) — 0412 874 331

Response: Voice
Airway: Patent. Nil airway obstruction. Strong odour of alcohol. Nil vomitus present.
Breathing: Spontaneous. Rate slightly slow but adequate depth. Nil audible wheeze or stridor.
Circulation: Radial pulse present, regular, adequate strength. Skin warm, flushed to face. Nil active bleeding.
Disability: GCS 12 (E3V4M5). Disoriented to time and place. Slurred speech. Pupils equal and reactive to light.
Exposure: Nil visible injuries. Nil rashes. Clothing dishevelled. No medic-alert jewellery noted.

Time	SpO2	Resp Dist	RR	Pulse	BP	CRT	GCS	PERL	Temp	BGL	Pain
Initial	96% (RA)	Nil	14	92	118/74	<2s	12	4 4 ++	36.9	5.4 mmol/L	0
10 mins	97% (RA)	Nil	14	88	120/76	<2s	13	4 4 ++	36.9	5.4 mmol/L	0

Diagnosis

This patient is suffering from acute alcohol intoxication without evidence of acute illness, injury, or medical emergency.

Facilitator Triggers — if trainees miss a critical step

! (If BGL is not checked within the first 5 minutes, the patient becomes increasingly drowsy and GCS drops to 10 — prompt trainees that BGL must be assessed in all patients with altered conscious state.)
! (If trainees do not perform a thorough head-to-toe assessment to rule out injury, inform them that security cannot confirm whether the patient fell — a secondary survey is required to exclude traumatic injury.)
! (If trainees attempt to leave the patient unsupervised or suggest discharge without further assessment, the patient attempts to stand and nearly falls — reinforce that ongoing monitoring is required.)

Treatment Objectives

1 Ensure scene safety and don appropriate PPE including gloves.
2 Perform Primary Survey — confirm patent airway, adequate breathing, pulse present, nil catastrophic haemorrhage.
3 Obtain BGL — result 5.4 mmol/L, hypoglycaemia excluded as cause of altered conscious state.
4 Apply pulse oximetry and obtain baseline vital signs.
5 Perform Secondary Survey — head-to-toe assessment to exclude traumatic injury (fall, head strike).
6 Obtain IMISTAMBO history — confirm alcohol as primary cause, exclude poly-drug use, obtain medication and allergy history.
7 Position patient safely — seated upright in FAP with ongoing supervision. Do NOT leave patient unattended.
8 Monitor patient persistently — repeat GCS and vital signs every 10 minutes.
9 Contact EHS Event Supervisor or CSP for advice regarding patient disposition if clinically indicated.
10 Document all findings and interventions on patient care record.
11 If patient deteriorates (GCS drops, airway compromise, vomiting) — place in lateral position, manage airway, and request ambulance.
12 Scenario ends on arrival of ambulance and IMISTAMBO handover.
13 Attention to hand hygiene will be given throughout the scenario.

Clinical references: Unconsciousness · Disturbed & Abnormal Behaviour · Blood Glucose Monitor · Primary Survey · Secondary & CNS Survey

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