Journal of education & teaching in emergency medicine最新文献

{"title":"A Case Report of an Unstable C-spine Fracture in the Emergency Department.","authors":"Jinho Jung, Tyler Rigdon, Alisa Wray, Danielle Matonis","doi":"10.21980/J8SK90","DOIUrl":"https://doi.org/10.21980/J8SK90","url":null,"abstract":"<p><p>Unstable cervical spine (c-spine) fractures are of high concern in traumatic incidents because they may result in significant morbidity and mortality. This is a case of a 44-year-old male who presents to the Emergency Department (ED) with neck pain after recreational wrestling and was found to have an unstable C-spine fracture. His treatment course was complicated by multiple interrupted hospital stays due to leaving against medical advice (AMA) and subsequent returns to the emergency department. The patient received both CT and MRI imaging and ultimately underwent occiput to C3 fusion with drain placement with a favorable outcome. This case report highlights the diagnosis and treatment of a patient with an unstable c-spine fracture. Key lessons from the case include the importance of timely recognition of patients with a potential c-spine fracture and identifying those who are at risk for nonadherence to medical treatment plans in order to provide interventions and improve chances of adherence. For patients in which pre-hospital care is involved, such as emergency medical services (EMS), recognition and appropriate care, such as c-spine stabilization, may be important for long-term outcomes.</p><p><strong>Topics: </strong>Unstable c-spine fracture, polysubstance use, spinal injury, neck trauma.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"V1-V5"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054094/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Hydropic Gallbladder Presenting as Right Lower Quadrant Abdominal Pain.","authors":"Savannah Tan, Zoe Adams, Scott Rudkin, Danielle Matonis","doi":"10.21980/J8DD26","DOIUrl":"https://doi.org/10.21980/J8DD26","url":null,"abstract":"<p><p>An 18-year-old female presented to the emergency department (ED) with two days of right lower quadrant pain and associated nausea and emesis. After relevant information was gathered and with physical exam findings of a tender right lower quadrant, positive psoas sign, positive Rovsing sign, and pain with right heel tap, the patient was presumed to have appendicitis. However, imaging contradicted the initial leading diagnosis and revealed a markedly distended, hydropic gallbladder with its tip near the umbilicus. Findings of the distended gallbladder with marked wall thickening and pericholecystic fat stranding and edema confirmed acute cholecystitis, and the patient was taken by general surgery for cholecystectomy. Together, this unusual presentation and this unexpected diagnosis shine light upon another facet of the hydropic gallbladder while also serving as a salient reminder to contemplate a broad differential regardless of seemingly classic presentations of illnesses.</p><p><strong>Topics: </strong>Cholecystitis, hydropic gallbladder, abdominal pain, appendicitis.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"V14-V16"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054074/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Orthopaedic Surgery Didactic Session Improves Confidence in Distal Radius Fracture Management by Emergency Medicine Residents.","authors":"Ian T Watkins, Jessica L Duggan, Aron Lechtig, Andrew Bauder, Luke He, Alexy Ilchuk, Amanda Doodlesack, Carl Harper, Tamara D Rozental","doi":"10.21980/J8K365","DOIUrl":"https://doi.org/10.21980/J8K365","url":null,"abstract":"<p><strong>Audience: </strong>This didactic session on distal radius fracture diagnosis and management is designed for Emergency Medicine (EM) residents of all levels.</p><p><strong>Introduction: </strong>With an incidence of 1,130 upper extremity injuries per 100,000 persons per year,1 distal radius fractures (DRFs) are the most common adult fracture, representing 17.5% of all fractures.2-4 Yet, many emergency medicine residents feel unprepared to manage DRFs independently upon graduation.5 The standard management of a fracture in the ED setting consists of identifying any urgent aspects of the fracture, controlling pain, performing a reduction if necessary, and applying a splint.6 Poor reduction or splinting techniques can lead to serious complications, including acute carpal tunnel or compartment syndrome, development of severe burns and rarely, amputation.6-8 Though it is common for emergency medicine (EM) resident trainees working in academic institutions to have regular access to orthopaedic surgery consultation, many will go on to practice in community settings or departments without access to full-time orthopaedic coverage. It is essential for EM residents to be familiar with DRF diagnosis and management, including closed reduction and splinting. We seek to create a toolbox for managing upper extremity fractures, with the overall purpose of improving orthopaedic care in the ED setting.</p><p><strong>Educational objectives: </strong>By the end of this didactic session, learners should be able to: 1) assess DRF displacement on pre-reduction radiography and formulate reduction strategies, 2) perform a closed reduction of a DRF, 3) apply a safe and appropriate plaster splint to patient with a DRF and assess the patient's neurovascular status, 4) assess DRF post-reduction radiography for relative fracture alignment, and 5) understand appropriate follow-up and necessary return precautions.</p><p><strong>Educational methods: </strong>Learners attended a didactic session led by orthopaedic surgery residents which included a faculty-approved lecture on DRFs and hands-on skills workshop on reducing the fractures and effectively applying plaster splints.</p><p><strong>Research methods: </strong>Prior to the educational session, participants completed a pre-workshop survey assessing current practices and baseline confidence regarding DRF management. Self-confidence levels for each skill were measured using a Likert scale from 0 (least confident) to 100 (most confident). Confidence levels were re-assessed immediately after the didactic session and three months later.</p><p><strong>Results: </strong>Nineteen emergency medicine (EM) residents (n=12, 63% female) across three class years (n=9, 47% PGY 1; n=6, 32% PGY 2; n=4, 21% PGY 3) completed the pre-workshop survey, and 15 residents participated in the didactic session and completed follow-up surveys. Fourteen (75%) EM residents reported reducing DRFs on their own (without an orthopaedic consult) less","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"SG1-SG9"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054089/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Eye-Opener: A Case Report of Eyelid Taping as Presenting Symptom of Myasthenia Gravis.","authors":"Mary G McGoldrick, Chirag N Shah","doi":"10.21980/J8NW8G","DOIUrl":"https://doi.org/10.21980/J8NW8G","url":null,"abstract":"<p><p>Myasthenia gravis (MG) is an autoimmune disorder of the neuromuscular junction that can cause various symptoms provoking a visit to the emergency department (ED). In this case, we present a 54-year-old female who reported having her eyes \"taped open\" for the last two months. Her history and physical exam findings in the ED raised suspicion for MG. The patient was subsequently admitted and started on pyridostigmine. An elevated acetylcholinesterase receptor-binding antibody level confirmed the diagnosis of MG. This case report highlights the characteristic progressive weakness of facial muscles in MG, emphasizing the importance of early recognition of MG symptoms by emergency clinicians in order to initiate appropriate management and prevent respiratory compromise and morbidity.</p><p><strong>Topics: </strong>Neurology, neurologic exam, myasthenia gravis, emergency medicine.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 2","pages":"V6-V9"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054071/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036283","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do's and Don'ts of Taking Care of Deaf Patients.","authors":"Luke Johnson, Sarah Smetana, Wyatte Hall, Aaron D Weaver, Jason Rotoli","doi":"10.21980/J8336T","DOIUrl":"10.21980/J8336T","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;Emergency medicine residents, fellows, and attending physicians, any practicing provider in a medical setting that may serve Deaf patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Emergency medicine providers often interact with Deaf and Hard of Hearing (DHH, or just HOH, for only hard of hearing) patients. Various limitations, however, affect their ability to effectively engage with DHH patients such as acuity, lack of time, and/or readily available communication tools (eg. virtual or in-person interpreters), among other challenges. These barriers contribute to numerous DHH healthcare disparities. Estimating the number of DHH people and ASL users in the US is challenging because the US Census Bureau inquires about hearing loss as it (1) pertains to interactions between a person speaking and the person (who may be experiencing hearing loss or deafness) being spoken to and (2) does not inquire if ASL is used in the home as a primary language.1,2 In reviewing data from the 2002 Survey of Income and Program Participation (SIPP), there were approximately 11 million people (4.1%) in the US with hearing loss and 1 million (0.38%) who are functionally deaf (unable to hear \"normal\" conversation at all).2 Best estimates of the number of &lt;i&gt;total people&lt;/i&gt; using sign language in the US come from survey data from the National Census of the Deaf Population in 1974.3 In this survey, it was noted that approximately 410,522 people have been signing in homes irrespective of hearing status (i.e. may include signing to hearing household members of DHH family). In considering prevocational deaf individuals (i.e. born deaf or lost the ability to hear before 19 years old), there are approximately 277,000 deaf people who are considered \"good signers.\"4 Understanding that the DHH community makes up an important portion of our patient population, we sought to design an educational intervention and infographic to demonstrate common pitfalls while caring for this marginalized group in the Emergency Department (ED). Not only does this community face difficulties navigating the health care system due to communication barriers and poor health literacy, but DHH and American Sign Language (ASL) users also appear to have higher rates of ED utilization than the general population of non-DHH individuals.5,6 Despite increased ED utilization, disparities persist such as extended door-to-disposition time, limited diagnostic studies, lack of IV placement, and lower likelihood of hospital admission.7,8 Our project sought to help mitigate these disparities by engaging a group of highly dedicated individuals seeking to improve the quality of care for DHH patients in our community. Collectively, we developed an instructional video and quick reference infographic to help educate providers in preferred communication strategies and in pitfalls to avoid while communicating with DHH patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;By the end of this didacti","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 1","pages":"L1-L8"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report on an Elusive Incident of Erythema Multiforme.","authors":"Cynthia Tsang, Savannah Tan, Lindsey Spiegelman","doi":"10.21980/J8BM0W","DOIUrl":"10.21980/J8BM0W","url":null,"abstract":"<p><p>The presentation of erythema multiforme in the emergency department is relatively rare, thus recognition and rapid intervention requires a high index of suspicion. This study presents a case of a 55-year-old female with past medical history of hypertension and active endometrial cancer with recent chemotherapy treatment complaining of four days of progressive erythematous rash with associated pruritis and blistering. An exam found multiple tense, scattered vesicles with an erythematous base. The patient also demonstrated leukopenia, elevated alkaline phosphatase level, and elevated C-reactive protein level. A shave biopsy was performed and intravenous acyclovir was started for concern of varicella-zoster virus. Biopsy results favored an erythema multiforme diagnosis, and she was discharged with topical clobetasol. In addition to reviewing the presentation and intervention of erythema multiforme, this case report adds to growing literature of erythema multiforme as a delayed reaction to malignancy therapy.</p><p><strong>Topics: </strong>Erythema multiforme, dermatology, radiotherapy.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 1","pages":"V17-V21"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801485/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case Report of Right Atrial Thrombosis Complicated by Multiple Pulmonary Emboli: POCUS For the Win!","authors":"Andrea Wolff, Evan Leibner, Jill Gualdoni","doi":"10.21980/J8TM07","DOIUrl":"10.21980/J8TM07","url":null,"abstract":"<p><p>A 78-year-old gentleman presented to the emergency department (ED) for palpitations and dizziness. He had a complicated medical history including atrial fibrillation (AF), recently status post a Watchman procedure, oxygen-dependent chronic obstructive pulmonary disease (COPD), and heart failure with preserved ejection fraction (HFpEF). Point-of-care ultrasound (POCUS) revealed the presence of an intracardiac right atrial thrombus. Computed tomography (CT) angiography confirmed the presence of multiple pulmonary emboli (PE), and extension of the thrombus into the inferior vena cava. Pulmonary emboli are a common complication of thrombus in the right atrium. Management may include anticoagulation, thrombolysis, or thrombectomy. This case highlights that emergency physicians can expedite the diagnosis of intracardiac thrombus by using POCUS. The case presented describes a medically complex patient presenting with symptomatic right intracardiac and inferior vena caval thrombosis complicated by multiple PE. Point-of care ultrasound of the heart and lungs were included in his initial assessment, revealing findings of an intracardiac thrombus, and ruling out multiple other differential diagnoses including pericardial tamponade, pleural effusion, pulmonary edema, and pneumothorax. This finding changed the trajectory of this patient's evaluation and management, and demonstrates the important role of POCUS in the care of ED patients with undifferentiated cardiopulmonary symptoms.</p><p><strong>Topics: </strong>Point-of care ultrasound (POCUS), focused cardiac ultrasound (FOCUS), inferior vena cava thrombosis, right atrial thrombosis, pulmonary embolism, computed tomography, echocardiography.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 1","pages":"V1-V11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801490/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retropharyngeal Abscess in an Adult Patient Presenting with Neck Fullness and Dysphagia: A Case Report.","authors":"Justin Rederer, Tanner Folster, Sara Dimeo","doi":"10.21980/J8M36G","DOIUrl":"10.21980/J8M36G","url":null,"abstract":"<p><p>Retropharyngeal abscess (RPA) is an uncommon yet potentially life-threatening condition that is more often seen in young children and may be misdiagnosed in adults presenting with atypical features.1 Retropharyngeal abscess results from spread of antecedent upper respiratory tract infection or traumatic inoculation via foreign body ingestion or medical instrumentation. Clinically, RPA may present with fever, pharyngitis, neck pain, and dysphagia. Diagnosis is often confirmed with imaging studies. We present a case of a 66-year-old female with asthma, hypertension, and gastroesophageal reflux disease (GERD) who presented to the emergency department (ED) for evaluation of neck fullness, shoulder pain, dysphagia, and abdominal pain starting less than 24 hours prior to presentation. Computed tomography (CT) revealed a prevertebral/retropharyngeal fluid collection from the odontoid tip to the C4 vertebral body measuring 5.4 × 1.0 × 3.3 centimeters (cm) in size with associated edema at the left neck base extending into the upper chest, suggestive of retropharyngeal abscess. The patient received intravenous (IV) vancomycin and piperacillin/tazobactam and was transferred to a higher level of care for otolaryngologist evaluation. The patient remained stable without airway compromise while in our department. This case underscores challenges in diagnosing atypical presentations of RPA in adults, emphasizing timely recognition to prevent complications.</p><p><strong>Topics: </strong>Dysphagia, retropharyngeal abscess, prevertebral abscess, otolaryngology.</p>","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 1","pages":"V12-V16"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Journal Court: A Novel Approach to Incorporate Medicolegal Education into an Emergency Medicine Journal Club.","authors":"Kevin McGurk, Mary Jordan, Bradley Davis","doi":"10.21980/J8093T","DOIUrl":"10.21980/J8093T","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;The target audience includes health professions students, residents, and fellows who participate in journal clubs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Journal club plays an important role in teaching emergency medicine residents how to critically evaluate medical literature and apply it to their clinical practice. While there is some consensus on the general goals and objectives of journal club, significant variability exists between how different residency programs design and conduct them.1 Papers selected may address similar or disparate topics, highlight specific research applications, or demonstrate diverging evidence on a specific issue.2-5 While numerous approaches have been implemented and described, they do not traditionally entail a trial-based format.More than 7% of practicing physicians have a malpractice claim annually and more than one third will be sued in their lifetime.6,7 Some estimates indicate 75% of emergency medicine physicians will be named in a medical malpractice suit during their career.8 Despite this, the American College of Graduate Medical Education (ACGME) has no specific requirement for medicolegal instruction during emergency medicine training.9 By structuring journal club to encompass a hypothetical medical malpractice lawsuit, our program sought to provide instruction on this topic while also fostering improved resident enthusiasm and participation.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;By the end of this exercise, participants should: 1) identify the four necessary elements for a malpractice claim, 2) understand the basic structure of medical malpractice litigation, and 3) critically analyze medical literature representing diverging viewpoints or conclusions.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational methods: &lt;/strong&gt;Residents read two papers regarding fluid resuscitation in sepsis and a fictional case narrative and associated medical malpractice complaint. The case described a septic patient with a history of congestive heart failure who clinically decompensates after large volume IV fluid administration.10,11 After a brief faculty-led discussion on medical malpractice, a mock trial was conducted. Rather than a more conventional journal club format, the two presenting residents discussed the papers by citing them as evidence in their role as expert witnesses providing testimony on behalf of the plaintiff or defense. Each expert witness explained the strengths of their respective paper and highlighted the weaknesses of the opposing paper. A jury made up of resident attendees then deliberated and rendered a verdict followed by an open discussion among the entire group regarding both papers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research methods: &lt;/strong&gt;At the conclusion of the journal club, residents in attendance were asked to complete a brief and anonymous survey evaluating the activity. Questions utilized a 5-point Likert scale to assess the journal club's utility for teaching about research appraisal and th","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 1","pages":"SG1-SG11"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096896/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol Withdrawal.","authors":"Patrick Meloy, Dan Rutz, Amit Bhambri","doi":"10.21980/J87S8Q","DOIUrl":"10.21980/J87S8Q","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Audience: &lt;/strong&gt;Emergency medicine residents and medical students on emergency medicine rotations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Alcohol use disorder (AUD) is common in the United States, with an estimated lifetime prevalence of 30%.1 The rate of use is higher among white males, Native Americans, and individuals of low socioeconomic status.1 Alcohol withdrawal symptoms manifest in 50% of individuals who misuse alcohol.1 While life-threatening sequelae of alcohol withdrawal are rare, the syndrome is a common reason for emergency department (ED) presentations. Alcohol withdrawal symptoms range from benign, cravings, nausea, anxiety and tremulousness, to life-threatening autonomic dysfunction, seizures, coma, and death.2 The pathophysiology of this clinical syndrome involves dysregulation of central nervous system (CNS) receptor function. Alcohol acts as a CNS depressant through activation of the CNS Gamma-aminobutyric acid (GABA) receptors. Chronic or heavy alcohol use results in downregulation of CNS inhibitory GABA receptors and upregulation of CNS excitatory &lt;i&gt;N&lt;/i&gt;-methyl-D-aspartate (NMDA) receptors.2 Upon discontinuation of alcohol use, this imbalance results in CNS hyperexcitability, creating the clinical symptoms of alcohol withdrawal.2 Symptoms typically manifest within eight hours after alcohol cessation, reach their peak in one to three days, and can extend for up to two weeks.3 Mild symptoms include anxiety, tremors, diaphoresis, nausea and/or vomiting. Severe symptoms include hallucinations (typically 12-24 hours after last alcohol intake) in 2-8% of patients, seizures (12-48 hours after last intake) in up to 15% of patients, and delirium tremens.3 Delirium tremens is a potentially fatal encephalopathy in patients experiencing alcohol withdrawal and occurs in 3-5% of patients approximately 72 hours after last alcohol intake.3 Without recognition or prompt treatment, mortality from delirium tremens can be as high as 50%.4 Management of alcohol withdrawal requires prompt recognition and control of symptoms. Most often this is accomplished by administering benzodiazepines, though alternative medications such as barbiturates, ketamine, or propofol are also used. Severe withdrawal may progress to intubation and mechanical ventilation.5 Given the high prevalence of AUD in the United States and the potential for life-threatening withdrawal symptoms, ED practitioners must recognize the spectrum of this disease and be comfortable with managing an array of presentations.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Educational objectives: &lt;/strong&gt;At the end of this oral boards session, learners will: 1) demonstrate the ability to perform a detailed history and physical examination in a patient presenting with signs and symptoms of alcohol withdrawal, 2) investigate the broad differential diagnoses, including electrolyte abnormalities, trauma in the intoxicated patient, mild alcohol withdrawal, and delirium tremens, 3) list appropriate laboratory and ima","PeriodicalId":73721,"journal":{"name":"Journal of education & teaching in emergency medicine","volume":"10 1","pages":"O1-O30"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11801492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143384314","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}