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    Patent Pending

    Hack’s Impairment Index (HII)

    Provides a quantitative and standardized assessment of the degree of alcohol-induced impairment in emergency department patients.

    INSTRUCTIONS

    Use this score to objectively track and monitor symptoms of impairment in patients who present to the Emergency Department with alcohol-induced impairment.

    When to Use
    Pearls/Pitfalls
    Why Use

    Use in patients presenting to the Emergency Department who display impairment after alcohol use.

    This score should not be used in patients who:

    • May have ingested other substances that may cause impairment.
    • Have had a seizure prior to arrival.
    • Are experiencing hypoglycemia.
    • Have other lab abnormalities or medical conditions that may contribute to impairment.
    • Should be used as part of a clinical assessment to determine time of least impairment after alcohol consumption, when the patient may be able to participate in disposition planning.
    • Should be used to monitor resolving impairment over time.
    • Should NOT be used to determine if safe/able to drive.
    • Should NOT be used as the sole factor in discharge planning.
    • To objectively monitor and track impairment resolution after alcohol consumption.
    • Does not require the user to have special training.
    • May be used at the bedside by any clinical team member.
    Normal or baseline speech; conversive and appropriate
    Imperfect speech; answers most questions appropriately
    Slurred speech; answers few questions appropriately
    Slurred speech; does not make sense
    Unintelligible speech or only moans
    Patient refused task
    Can stand and walk, and is steady
    Can stand and walk, but is unsteady
    Can sit up and is steady, but cannot stand
    Can sit up, but is unsteady
    Cannot sit up
    Patient refused task
    No nystagmus; follows finger with eyes whole time
    Minimal nystagmus; follows finger with eyes whole time
    Moderate nystagmus; only follows finger with eyes for short distance
    Profound nystagmus; unable to follow finger with eyes
    Unable to participate
    Patient refused task
    Steady; accurate finger to target
    Steady; inaccurate but touches target
    Unsteady; inaccurate, barely touches target
    Grossly unsteady; misses finger to target
    Unable to participate
    Patient refused task
    Traces curve perfectly
    Traces mostly inside lines
    Traces mostly outside lines
    Makes mark on paper
    Unable to participate
    Patient refused task

    Result:

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    Next Steps
    Evidence
    Creator Insights
    Dr. Jason B. Hack

    About the Creator

    Jason B Hack, MD is currently a professor of emergency medicine, Chief, Division of Medical Toxicology, Vice Chair of Research at East Carolina University, in Greenville, NC. He was awarded the University Emergency Medicine Foundation’s (UEMF) Mid-Career Academic Development Award for development and investigation of a novel alcohol intoxication assessment tool. Dr. Hack’s primary research is focused on alcohol intoxication and withdrawal, drug abuse, innovative approaches towards clinical issues, and medicinal and poisonous plants.

    To view Dr. Jason B. Hack's publications, visit PubMed

    Are you Dr. Jason B. Hack? Send us a message to review your photo and bio, and find out how to submit Creator Insights!
    MDCalc loves calculator creators – researchers who, through intelligent and often complex methods, discover tools that describe scientific facts that can then be applied in practice. These are real scientific discoveries about the nature of the human body, which can be invaluable to physicians taking care of patients.
    About the Creator
    Dr. Jason B. Hack
    Are you Dr. Jason B. Hack?