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急诊科中阿片类药物戒断和阿片类药物使用障碍的识别与治疗。

Identification and Treatment of Opioid Withdrawal and Opioid Use Disorder in the Emergency Department.

机构信息

Assistant Professor, Department of Emergency Medicine, Medical University of South Carolina.

Resident Physician, Department of Emergency Medicine, Medical University of South Carolina.

出版信息

MedEdPORTAL. 2020 May 15;16:10899. doi: 10.15766/mep_2374-8265.10899.

Abstract

INTRODUCTION

Opioid addiction and misuse constitute a public health crisis in the United States. Recent research supports buprenorphine induction in the emergency department (ED) setting for patients with opioid use disorder (OUD). However, education regarding buprenorphine induction for emergency medicine (EM) physicians, residents, and students is still limited.

METHODS

We created a 1-hour introductory workshop for the identification and treatment of opioid withdrawal and OUD in the ED for medical students going into EM and for EM interns. The workshop consisted to two distinct curricular sections: (1) a didactic session providing an overview of the basic knowledge and skills to identify and treat patients with OUD in the ED and (2) a case-based session in which students worked through the identification of opioid withdrawal; discussion of opioid use with the patient, going through the steps of SBIRT (screening, brief intervention, and referral to treatment); and considerations when starting buprenorphine. The workshop was evaluated using a pre- and posttest examining medical knowledge around buprenorphine use in the ED.

RESULTS

A total of 48 students and interns participated in the curriculum. The students showed a significant improvement in medical knowledge between the pre- and posttests, with an average 45% higher score on the posttest ( < .001).

DISCUSSION

Our workshop resulted in a short-term improvement in medical students' and interns' knowledge of the identification and treatment of patients with OUD in the ED.

摘要

简介

阿片类药物成瘾和滥用在美国构成了公共卫生危机。最近的研究支持在急诊部(ED)环境中为阿片类药物使用障碍(OUD)患者进行丁丙诺啡诱导。然而,针对急诊医学(EM)医师、住院医师和学生的丁丙诺啡诱导教育仍然有限。

方法

我们为即将进入急诊医学的医学生和急诊医学住院医师创建了一个 1 小时的介绍性研讨会,内容是在 ED 中识别和治疗阿片类药物戒断和 OUD。该研讨会由两个不同的课程部分组成:(1) 一个理论课程,提供了在 ED 中识别和治疗 OUD 患者的基本知识和技能概述;(2) 一个基于案例的课程,学生在其中通过识别阿片类药物戒断、与患者讨论阿片类药物使用、完成 SBIRT(筛查、简短干预和转介治疗)步骤、以及开始使用丁丙诺啡时的注意事项。该研讨会通过前后测试进行评估,测试内容是关于 ED 中使用丁丙诺啡的医学知识。

结果

共有 48 名学生和住院医师参加了该课程。学生在前后测试中的医学知识都有显著提高,后测平均得分提高了 45%(<0.001)。

讨论

我们的研讨会在短期内提高了医学生和住院医师在 ED 中识别和治疗 OUD 患者的知识。

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