Teenage parties - when things go wrong: An ER nurse's perspective

When a parent is asked by their teen if they can attend a friend's party on a Saturday night, most would assume that the details their child provides them about the event, (e.g., where it is being held, the names of the host parents and the time it starts and plans to finish) would be reasonably accurate. You have to trust your teen, particularly as they get older, even if they're likely to break that trust at some time or another - that's what adolescents do! But when it comes to parties and gatherings, it's always best to go to some other sources to establish exactly what's going on … 

Any parent who makes the decision to hold a teenage party at their home (or anywhere else for that matter) is pretty 'gutsy'. It takes a great deal of thought and planning to organise such an event and it is important to acknowledge that we see hundreds held every weekend right across the country that have few, if any, problems. Increasingly, those parents who do host these events take the time to put a range of strategies into place that ensure the partygoers are kept as safe as possible, their homes and the homes of their neighbours are not put at risk and everyone has a great time!

Unfortunately, it's what is happening before and after these events that is increasingly becoming an issue for frontline workers. When it comes to parenting and parties, there really is only one 'non-negotiable' - only you make the decision about how they get to the event and how they get home. They can certainly provide you with their desired option (there can even be a little bit of negotiation and 'meeting in the middle' as they get older) but if you want to keep your teen safe, this is the only area where you have to play 'hardball'. The best option, of course, is that you take them and you pick them up, but that's not always going to be possible (some parents do actually have social lives!) - so if you're not, talk to the person who will be. If you speak to any frontline worker, they will tell you that so many of the problems they see on a Saturday night occur when young people are wandering the streets, their parents totally unaware of where they are ...  

Last week, a paramedic shared a couple of stories around parties and what she has had to deal with in this area. This week, Russell, an Emergency Department nurse highlights the challenges a hospital faces when a drunk young person is brought in after leaving a party:

Emergency Departments (ED) are always busy, and Saturday nights particularly so. At 1.30am, an unidentified teenage male was brought in by ambulance after being picked up in a local park following a 1.10am call to 000 by an unknown caller. The ambulance officer reported that three empty 750ml bottles of Jack Daniels had been found at the scene, and that there was evidence that other people had been present recently. 

The patient was assessed by the triage nurse and immediately taken to 'resus' – the part of the ED that is staffed and equipped to care for patients with the highest acuity. On examination, the patient was only responding to painful stimulus, he was snoring, his breathing was shallow and slow, and he smelled of alcohol and vomit. We had no way of knowing what the patient had consumed, apart from alcohol, nor when he had had his last drink or how long he had been in this state. Because of this, it was going to be difficult to assess whether his condition was going to continue to deteriorate. 

In this situation, protecting the patient's airway is essential. If he vomited while unconscious, his lungs could fill with vomit and he could die. A team of three doctors and three nurses prepared to intubate our patient to protect his airway. The lead ED consultant assessed the young man's level of consciousness once more before proceeding and by this time he was now responding to voice. His speech was slow and slurred but we were able to discern his name and date of birth. Ethan (not his real name) was 15-years-old.

The lead ED consultant put our plans to intubate on hold while we continued to assess Ethan. We sat him upright on the bed with two nurses ensuring that he didn't fall. Ethan insisted that apart from alcohol he had taken no other drugs … "just a bit of weed". One of the greatest problems we face when young people arrive in this state is trying to establish exactly what a young person has taken. It is so important that their friends share that information with a doctor, nurse or ambulance officer - our only concern is for the preservation of life - we're not collecting it for the police. Providing accurate information could make the difference between life and death.

While this had all been happening, the ED administrative officer had been able to contact Ethan's parents. Ethan's Dad, David, arrived twenty minutes later. He was able to tell us about Ethan's medical history. He said that nothing like this had ever happened to Ethan before. David was visibly shaken by his son's appearance in the resus bay.  We reassured him that although Ethan's level of consciousness was varying, it was gradually improving. David was also particularly upset at the prospect of his son being found unconscious and alone in a park in the middle of the night. Ethan had told his Dad that he was sleeping over at a friend's place after attending a party earlier in the night.

Caring for family members in situations like this is an important part of a nurse's job.  We explained our plan with David and gained his consent to proceed. He was a little calmer knowing what to expect over the next few hours.  We gave him a cup of tea, a sandwich, a blanket and chair so that he could sit with his son until it was safe to take him home.  
Our job is to treat the people who come into the ED. When teens are brought in, it can be particularly traumatic, especially for those staff who have children of their own. Watching parents turn up after getting a call to say that their child has been transported to hospital is also upsetting. Over and over again, when they are told what has happened you hear them say that they thought they were at a "friend's house" or, if they were found alone, "Where were their mates? I thought they were with ..." It becomes obvious that so many of them have little, if any, idea where their child was that night or what they were doing.
Sadly, we see too many teens in the ED who arrive in a drunken, unconscious state - some of them left by their friends because they're obviously frightened of getting into trouble. An unconscious patient represents a medical emergency. Young people need to be reminded regularly that if the need arises they should call 000. They also need to stay with their friend until help arrives.  The information they provide to healthcare workers may save their friend's life and/or simplify their care. 

As Russell points out, David believed that his 15-year-old son was staying over at a friend's house after attending a party. Let me make it clear here that I'm not trying to blame anyone for what happened to Ethan, parenting is difficult and at some point you have to trust your teen to tell you the truth about where they're going, who they're with and what they're planning to do but we're talking 15 here … Would it really have taken too much effort for David to make a call to the parent who was supposedly going to pick his son up from the party and find out what was being planned? I'm sure all of that (and a whole pile of other things) went around and around in his head as he sat in that Emergency Department waiting for his son to recover …

Teen parties can be dangerous places. Parents who allow their children to attend these events put their trust in the host parents to do their best to look after the partygoers while they are in their care. The state in which they arrive and what goes down when they leave, however, is not their responsibility (although I have met many parents who've had to deal with heavily intoxicated 14-year-olds turning up at their door and done their best to make sure they're safe, as well as others who have refused to let a group of 15-year-olds wander off to goodness knows where once a party ends and no-one turns up to pick them up!). As already said, taking your teen to where they're going on a Saturday night and then picking them up is always going to be the safest option. You're not going to have much of a social life for a few years but, to be honest, that's what you signed up for!!

Frontline workers, like Russell and so many others, regularly pick up the pieces when things go wrong on a Saturday night. That's their job and I'm sure they wouldn't have it any other way. That said, incidents such as the one described above are totally preventable - all it would take is a little bit more effort in the parenting department occasionally. Dropping your son or daughter off to wherever they're going when you are able, making that quick phone call to talk to other parents when you're not and just doing a little bit more 'age-appropriate monitoring' can make all the difference. It's likely to keep your teen safer, as well as potentially lighten the load on all those amazing people who work on the frontline every weekend!