Alcohol Withdrawal with Delirium Tremens

Area of Science:

• Medical Education
• Emergency Medicine
• Simulation-Based Learning

Background:

• Alcohol withdrawal (AW) is a significant cause of morbidity and mortality, with an incidence of 1.9-6.7% in hospitalized heavy alcohol users.
• AW in the emergency department (ED) is associated with increased critical care resource utilization and mortality rates, especially when progressing to delirium tremens (DTs).
• Recognizing and managing AW, including altered mental status and severe autonomic dysfunction, is crucial for emergency physicians.

Purpose of the Study:

• To evaluate the effectiveness of high-fidelity simulation in educating emergency medicine residents on the management of alcohol withdrawal with delirium tremens.
• To assess learner's ability to diagnose, manage, and treat patients presenting with altered mental status and symptoms of AW.

Main Methods:

• A high-fidelity simulation session followed by debriefing was conducted for first-year EM residents.
• Thirty-two EM residents participated, with 16 actively managing a simulated patient and 16 observing.
• Post-session online surveys using a 5-point Likert scale assessed the realism, complexity, and educational benefit of the simulation and debriefing.

Main Results:

• 100% of 15 respondents agreed or strongly agreed that the simulation case improved medical knowledge and patient care.
• All participants found the post-session debriefing helpful.
• Median responses indicated high satisfaction with the case's realism and complexity.

Conclusions:

• High-fidelity simulation is a cost-effective and realistic method for teaching AW and DTs management to EM residents.
• The simulation effectively prepared learners to manage patients with altered mental status, progressing to severe agitation and autonomic dysfunction.
• Learners reported significant benefits in acquiring knowledge and skills for managing alcohol withdrawal.