Psych CASC / OSCE · Addiction psychiatry
Explaining alcohol withdrawal, seizures, DT, and thiamine — CASC communication station
MRCPsych/FRANZCP-style communication station: explain AWS timeline, seizure and DT risk, CIWA-guided benzodiazepine detox as short-term medical treatment, parenteral thiamine/Wernicke prevention, inpatient criteria next time, non-stigmatising recovery framing.
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Station brief
Format. Communication station, approximately 7–10 minutes after reading time. You are the psychiatry registrar. [6]
Candidate instructions. Acknowledge anger and fear; explain in plain language why seizures and delirium can occur after stopping heavy drinking; explain short-term benzodiazepines guided by symptom scores (CIWA); explain thiamine injections for brain protection; discuss why future detox should be supervised inpatient given complicated withdrawal; offer hope and follow-up without stigma. Check understanding. [1][2][5]
References6ShowHide
- [1]Schuckit MA Recognition and management of withdrawal delirium (delirium tremens). N Engl J Med, 2014.PMID 25427113
- [2]Mayo-Smith MF Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline. JAMA, 1997.PMID 9214531
- [3]Sullivan JT, Sykora K, Schneiderman J, et al. Assessment of alcohol withdrawal: the revised clinical institute withdrawal assessment for alcohol scale (CIWA-Ar). Br J Addict, 1989.PMID 2597811
- [4]Galvin R, Bråthen G, Ivashynka A, et al. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol, 2010.PMID 20642790
- [5]ASAM The ASAM Clinical Practice Guideline on Alcohol Withdrawal Management. J Addict Med, 2020.PMID 32511109
- [6]Connor JP, Haber PS, Hall WD Alcohol use disorders. Lancet, 2016.PMID 26343838