These cases come to us from Drs. Jessica Pelletier and Anne Ickes.
Jessica Pelletier, DO is an Emergency Medicine Education Fellow at Washington University School of Medicine in St. Louis. Her interests include harm reduction, the use of simulation for difficult conversations and procedural preparedness, and the use of osteopathic manipulation for pain control in the emergency department. Dr. Pelletier enjoys emergency medicine podcasts and hopes to contribute to the Free Open Access Meducation (FOAMed) literature through podcasting. She plans to pursue a career in residency leadership with a focus in resident education.
Anne Ickes, DO is currently an Addiction Fellow at Virginia Tech Carilion School of Medicine. She completed her Emergency Medicine Residency at Carilion as well. She is interested in treating opioid and alcohol use disorders to decrease Emergency Medicine visits and harmful adverse outcomes related to substance use.
WHY IT MATTERS
Alcohol use disorder is markedly prevalent among patients presenting to the ED, but we often fail to recognize it or provide patients with appropriate resources for referral. The first case aims to equip emergency medicine residents to identify and manage patients presenting with complications of alcohol use.
The second case addresses the important concept of opioid agonist therapy (OAT) for opioid use disorder. Recognition of opioid withdrawal and prompt offering of OAT to patients who will benefit can be life saving.
CASE SUMMARY
A 29-year-old male presents to the emergency department (ED) after falling in the shower while intoxicated. He lost consciousness and does not remember the nature of the events that brought him to the ED. After performing an appropriate trauma evaluation and workup, learners should engage the patient in screening, brief intervention, and referral to treatment (SBIRT) to reduce his risk for future adverse outcomes related to his alcohol use.
A 21-year-old female is brought into the ED after an opioid overdose. She is in acute opioid withdrawal and will require appropriate management including offering of opioid agonist therapy with ED initiation of buprenorphine-naloxone.
EM Sim Cases 