The EM Educator Series: Why did the patient with alcohol dependence stop drinking?

Author: Alex Koyfman, MD (@EMHighAK) // Editor: Brit Long, MD (@long_brit)

Welcome to The EM Educator Series. These posts provide brief mini-cases followed by key questions to consider while working. The featured questions provide important learning points for those working with you, as well as vital items to consider in the evaluation and management of the specific condition discussed. This first post discusses several components of alcohol use in the ED.

Mini-case #1:

Why did the patient with alcohol dependence stop drinking?

1) How does alcohol withdrawal present?

2) Why do we miss alcohol withdrawal early? What are other high-risk patients for cognitive error that we see in the ED?

3) Triggers for alcohol withdrawal

4) Ketoacidosis – diabetic / starvation / alcoholic: identification and management

5) Approach to AGMA – KULT (Ketones / Uremia / Lactate / Toxins)

Addiction Medicine, courtesy of Dr. Katelyn Hanson of Hanson’s Anatomy.

Suggested resources:

http://www.emdocs.net/alcohol-withdrawal/

https://emergencymedicinecases.com/alcohol-withdrawal-delirium-tremens/

https://emblog.mayo.edu/2015/07/27/alcoholic-ketoacidosis/

https://lifeinthefastlane.com/ccc/alcoholic-ketoacidosis/

http://www.emdocs.net/toxcards-alcohol-ketoacidosis/

https://lifeinthefastlane.com/ccc/ketoacidosis/

https://emergencymedicinecases.com/metabolic-acidosis/