Guideline 74: The management of harmful drinking and alcohol dependence in primary care

The management of harmful drinking and alcohol dependence in primary care
Annex 4

The one minute Paddington Alcohol Test (PAT)¹⁵⁷

Please complete for ALL A&E PATIENTS where there is any INDICATION OF ALCOHOL MISUSE:
eg assault, head especially facial injury, fall, non-specific gastrointestinal problem, “unwell”, fit, blackout, collapse, insomnia, sweating, hypo/hyperglycaemia, palpitations, chest pain, gout, rashes, depression, overdose; note REPEAT attendance (perhaps with unexplained symptoms) and DELAYED attendance >4 hours (perhaps intoxicated at the time of “incident”).
Remember the elderly presenting with: falls, confusion, incontinence and self neglect.

1. Quite a number of people have times when they drink more than usual; what is the most you will drink in any one day?
N.B. Please note if home or pub measures. Units (1 unit = 8 grams alcohol) relating to pub measures, are shown in brackets.

TYPE OF DRINK	AMOUNT
Beer/Lager/Cider	Pints (2) or Cans (1.5) ____=Units/day
Strong Beer/Lager/Cider	Pints (5) or Cans (4)
Wine	Glasses (1.5) or Bottles (9)
Fortified Wine (Sherry, Martini)	Glasses (1) or Bottles (12)
Spirits (Gin, Whisky, Vodka)	Singles (1) or Doubles (2) or Bottles (30)

2. If this is more than 8 units/day for a man, or 6 units/day for a woman, does this happen:
Once a week or more? YES: PAT +ve
or
Between once a month and once a week? YES: PAT +ve
or
Neither (ie once a month or less)? YES: PAT -ve (go to Question 3)

3. Do you feel your current attendance in A&E is related to alcohol?
YES: PAT +ve
NO: PAT -ve
ie PAT +ve if >8 units male or 6 units female more than once a month, and/or YES to Question 3.