This is a simulation case involving a patient presenting to the emergency room with symptoms of alcohol withdrawal. It is intended for the education of emergency medicine residents, internal medicine residents, family practice residents, or medical students. The scenario focuses on the recognition and management of alcohol withdrawal syndrome. It also emphasizes the importance of a thorough social history and obtaining additional information from family.
The case covers the full spectrum of symptoms from vague presentation to need for critical interventions. It emphasizes the importance of taking a full history especially in conditions that do not have definitive diagnostic test. Residents learn about treatment options and how to prevent and manage potential complications. After the case residents are given the opportunity to review the four stages of alcohol withdrawal syndrome, and the pathophysiology of alcohol addiction and withdrawal are discussed. Finally, there is discussion regarding the morbidity and mortality of a condition with the potential to be missed due to its initial benign complaints.
- Obtain a thorough history, including a social history of quitting alcohol recently.
- Elicit additional information from family if a patient is unable to give history.
- Diagnose alcohol withdrawal syndrome based on history and clinical presentation.
- Initiate treatment of alcohol withdrawal syndrome and prevent or manage additional complications.
- Disposition the patient to an appropriate level of care based on condition.
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