Toolkit for Alcohol-Related Presentations to the Emergency Department

This toolkit was created for ED providers, including counsellors, nurses, nurse practitioners, peer support workers, pharmacists, physicians, and social workers. These tools address the effective treatment of alcohol withdrawal, management of other alcohol-related presentations, brief counselling interventions, initiation of anti-craving medications, and referral to community resources. The tools include evidence-informed recommendations, order sets, algorithms, sample prescriptions, and patient materials. You can download the entire toolkit or the individual tools (see below).

Introduction to the Toolkit for Alcohol-Related Presentations to the Emergency Department

Recommendations

Recommendations on the Management of Selected Alcohol-Related Presentations in the Emergency Department

These recommendations for the management of alcohol-related emergency department (ED) presentations were developed by a group of people with professional and/or experiential expertise of alcohol use.
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

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Summary of Recommendations on the Management of Selected Alcohol-Related Presentations in the Emergency Department

A summary of recommendations of how to manage alcohol-related emergency department (ED) presentations.
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

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Special Considerations for Alcohol-Related Presentations in the ED

Selected special considerations to keep in mind when providing care to emergency department (ED) patients with alcohol-related presentations.
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

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Order Sets and Algorithms

ED Order Set for Alcohol Withdrawal

An order set for managing alcohol withdrawal in the emergency department (ED).
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

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Choosing an Anti-Craving Medication

An algorithm for choosing an anti-craving medication for emergency department (ED) patients.
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

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Approach to ED Patients With Alcohol-Related Presentations

A flow sheet outlining an approach to patients presenting to the emergency department (ED) with an alcohol-related concern.
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

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Discharge

Alcohol Withdrawal Management Prescription

An alcohol withdrawal management prescription template (for gabapentin, diazepam, or lorazepam) for patients being discharged from the emergency department (ED)
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

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ED Naltrexone, Gabapentin, and Acamprosate Prescription

An anti-craving prescription template for patients being discharged from the emergency department (ED).
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

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Naltrexone Discharge Information for Primary Care

A template for a discharge note to primary care after a client has been started on naltrexone in withdrawal management.
Part of WMS toolkit
Version date: 25 January 2024

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Acamprosate Discharge Information for Primary Care

A template for a discharge note to primary care after a client has been started on acamprosate in withdrawal management.
Part of WMS toolkit
Version date: 25 January 2024

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Gabapentin Discharge Information for Primary Care

A template for a discharge note to primary care after a client has been started on gabapentin in withdrawal management.
Part of WMS toolkit
Version date: 25 January 2024

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Patient-Facing Documents

Substance Use Emergency Department Poster

An emergency department (ED) waiting room poster that encourages patients to talk about their substance use.
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

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Emergency Department Patient Handout: Thinking About Drinking: Risky Drinking, Alcohol Use Disorder, and What You Can Do

A handout for patients attending the emergency department (ED) for an alcohol-related concern
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

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Training

CAMH Course: Introduction to the CIWA-Ar

An e-learning module for emergency department (ED) providers on using the Clinical Institute Clinical Institute Withdrawal Assessment for Alcohol Revised (CIWA-Ar) assessment to measure alcohol withdrawal in the emergency department (ED)
Created by the Centre for Addiction and Mental Health (CAMH)

Link
Clinical Institute Withdrawal Assessment for Alcohol Revised (CIWA-Ar) Training Tool

A training tool on conducting a Clinical Institute Withdrawal Assessment for Alcohol Revised (CIWA-Ar) assessment to measure alcohol withdrawal in the emergency department (ED).
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

PDF

Sample Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) assessment.
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

Video
Brief Negotiated Interviews (BNI)

An overview of delivering a brief negotiated interview (BNI) for alcohol use in the emergency department (ED).
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

PDF

Sample brief negotiated interview (BNI) for alcohol use in the ED.
Part of Toolkit for Alcohol-Related Presentations to the Emergency Department
Version date: 15 December 2023

Video

Robert Blackwell, Community Consultant
Bjug Borgundvaag MD PhD CCFP(EM)
Katie Dunham NP
Charlene Fraser, Community Consultant
Ruben Hummelen MD PhD CCFP
Meldon Kahan MD CCFP FRCPC
Kate Lazier MD CCFP(EM)
Robyn Nocilla BScN MSc NP-PHC
Kelly Shillington RN MScN ENC(C)
Ginette Thivierge RN, Community Consultant
Marcel Wagner RPh
Jennifer Wyman MD MPH

Chris Chan RPh
Janelle Hannon MSW RSW
Christina Henry BA BScN RN
Laura Jones NP
Michelle Klaiman MD FRCPC(EM)
Justin J. Koh MD MPH FRCPC
Bryan Marshall SSW, Community Consultant
Adam McInnis RN BScN MScCH MN-NP (student), Community Consultant
Patrick Nowak RN BScN
Lori Regenstreif MD CCFP(AM)
Julie Samson MD CCFP(EM)
Hasan Sheikh MD CCFP(EM)
Elizabeth Shouldice MD CCFP(AM)
Anita Srivastava MD MSc