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Free Open Access Short Answer Questions for ED Fellowship Study

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Case: Complex Alcohol Withdrawal

A 45-year-old man presents to a rural Emergency Department with tremors, agitation, anxiety and diaphoresis. He reports stopping alcohol three days ago after over 10 years of heavy daily alcohol use.

  • HR 130
  • BP 130/90
SaO2 98% RA
  • RR 24
T 37.6
  • GCS 15

1. List 4 clinical features that support the diagnosis of alcohol withdrawal syndrome in this patient. 4 marks

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2. List 4 risk factors that increase the likelihood of progression to severe alcohol withdrawal. 4 marks

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You determine this patient to have complex alcohol withdrawal.

3. State key components of your initial ED management. Include relevant drugs and doses. 4 marks

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4. List clinical indications for the use of oxazepam instead of diazepam in the management of alcohol withdrawal. 3 marks

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Your patient then develops worsening agitation, tremor, diaphoresis and hallucinations.

5. List adjunctive treatments or supportive care strategies required in the management of this patient now. Include doses where applicable. 3 marks

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