Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE‐4): Alcohol use disorder and cannabinoid hyperemesis syndrome management in the emergency department

Author:

Borgundvaag Bjug1ORCID,Bellolio Fernanda2ORCID,Miles Isabelle3ORCID,Schwarz Evan S.4ORCID,Sharif Sameer5ORCID,Su Mark K.6ORCID,Baumgartner Kevin7ORCID,Liss David B.7ORCID,Sheikh Hasan8ORCID,Vogel Jody9ORCID,Austin Emily B.10ORCID,Upadhye Suneel11ORCID,Klaiman Michelle12ORCID,Vellend Robert13,Munkley Anna13,Carpenter Christopher R.2ORCID

Affiliation:

1. Schwartz/Reisman Emergency Medicine Institute, Sinai Health System, Department of Family and Community Medicine University of Toronto Toronto Ontario Canada

2. Department of Emergency Medicine Mayo Clinic Rochester Minnesota USA

3. Department of Emergency Medicine University of British Columbia Vancouver British Columbia Canada

4. Department of Emergency Medicine University of California Los Angeles Los Angeles California USA

5. Department of Medicine, Division of Critical & Emergency Medicine McMaster University Hamilton Ontario Canada

6. The Ronald O. Perelman Department of Emergency Medicine, Division of Medical Toxicology New York University Grossman School of Medicine New York New York USA

7. Department of Emergency Medicine, Division of Medical Toxicology Washington University in St. Louis School of Medicine St. Louis Missouri USA

8. Toronto General Hospital Research Institute, Department of Family and Community Medicine University of Toronto Toronto Ontario Canada

9. Department of Emergency Medicine Stanford University Stanford California USA

10. Divisions of Emergency Medicine and Clinical Pharmacology & Toxicology University of Toronto Toronto Ontario Canada

11. Division of Emergency Medicine McMaster University Hamilton Ontario Canada

12. Emergency Department, St. Michael's Hospital, Unity Health Toronto, Division of Emergency Medicine University of Toronto Toronto Ontario Canada

13. Patient Representative Toronto Ontario Canada

Abstract

AbstractThe fourth Society for Academic Emergency Medicine (SAEM) Guidelines for Reasonable and Appropriate Care in the Emergency Department (GRACE‐4) is on the topic of the emergency department (ED) management of nonopioid use disorders and focuses on alcohol withdrawal syndrome (AWS), alcohol use disorder (AUD), and cannabinoid hyperemesis syndrome (CHS). The SAEM GRACE‐4 Writing Team, composed of emergency physicians and experts in addiction medicine and patients with lived experience, applied the Grading of Recommendations Assessment Development and Evaluation (GRADE) approach to assess the certainty of evidence and strength of recommendations regarding six priority questions for adult ED patients with AWS, AUD, and CHS. The SAEM GRACE‐4 Writing Team reached the following recommendations: (1) in adult ED patients (over the age of 18) with moderate to severe AWS who are being admitted to hospital, we suggest using phenobarbital in addition to benzodiazepines compared to using benzodiazepines alone [low to very low certainty of evidence]; (2) in adult ED patients (over the age of 18) with AUD who desire alcohol cessation, we suggest a prescription for one anticraving medication [very low certainty of evidence]; (2a) in adult ED patients (over the age of 18) with AUD, we suggest naltrexone (compared to no prescription) to prevent return to heavy drinking [low certainty of evidence]; (2b) in adult ED patients (over the age of 18) with AUD and contraindications to naltrexone, we suggest acamprosate (compared to no prescription) to prevent return to heavy drinking and/or to reduce heavy drinking [low certainty of evidence]; (2c) in adult ED patients (over the age of 18) with AUD, we suggest gabapentin (compared to no prescription) for the management of AUD to reduce heavy drinking days and improve alcohol withdrawal symptoms [very low certainty of evidence]; (3a) in adult ED patients (over the age of 18) presenting to the ED with CHS we suggest the use of haloperidol or droperidol (in addition to usual care/serotonin antagonists, e.g., ondansetron) to help with symptom management [very low certainty of evidence]; and (3b) in adult ED patients (over the age of 18) presenting to the ED with CHS, we also suggest offering the use of topical capsaicin (in addition to usual care/serotonin antagonists, e.g., ondansetron) to help with symptom management [very low certainty of evidence].

Funder

Society for Academic Emergency Medicine

Publisher

Wiley

Cited by 2 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3