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​​ SMART Psyciatric Medical Clearance Form 

Hack’s Impairment Index (HII) Score

HII is a tool used to formally assess clinical intoxication from alcohol. It is intended to supersede the need to obtain blood alcohol levels (BALs) when performed in conjunction with the screening of potential alcohol withdrawal. While used to test intoxication, it is not meant as an exact comparison to a breath/blood alcohol test, but rather, to aid in clinical decisions regarding a patient. The test should be completed on all patients that are clinically intoxicated (and/or provide history of recent alcohol). This should be repeated as needed until the HII is less than four. Blood or breath alcohol testing is not required for medical clearance, unless otherwise clinically indicated.

Currently, we advise clinicians to use their best judgement when assessing sobriety of patients under the influence of non-alcohol substances, including, but not limited to, the Hack’s Impairment Index.

Online Toolkit:

Download HII Score PDF here

Additional Resources

Smart Clearance FormPDF  |  Cover LetterPDF  |  Hack's Impairment Index (HII) ScorePDF