An EM Intern's Misadventure and Lessons in Sleep and Wellness

JEM reports Pub Date : 2023-11-26 DOI:10.1016/j.jemrpt.2023.100059

Rebekah Riordan

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Abstract

Background

Burnout, mental health issues, and sleep disorders continue to be a problem among emergency medicine physicians, affecting patient care, personal well-being, and retention of the specialty.

Case report

A 35-year-old female emergency medicine intern is brought in by her assistant program directors for altered mental status and ataxia, concerning for alcohol or drug intoxication. It was noted that she was confused, oriented only to self, and seemed to be experiencing auditory hallucinations. Also noted was she was tremulous and exhibited an ataxic gait. However, lab testing was inconsistent with drug or alcohol intoxication. During her hospital admission, it was discovered she had been awake over 80 hours after gaining collateral from friends and family. With the administration of a large amount of trazodone, she eventually fell asleep and was later diagnosed with four different sleep disorders and successfully treated by sleep specialists. This case is discussed here to bring more awareness to the poor state of wellness in the emergency medicine specialty and to suggest practical ways to address these multifactorial issues.

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一名电磁学实习生的不幸遭遇以及睡眠和健康方面的经验教训

职业倦怠、精神健康问题和睡眠障碍一直是急诊科医生面临的一个问题，影响着病人护理、个人健康和专业的保留。病例报告一名35岁的女性急诊医学实习生被她的助理项目主任带进医院，治疗精神状态改变和共济失调，涉及酒精或药物中毒。人们注意到，她很困惑，只以自我为导向，似乎正在经历幻听。同样值得注意的是，她浑身发抖，步态失调。然而，实验室检测与药物或酒精中毒不一致。在她住院期间，在得到朋友和家人的担保后，她被发现已经清醒了80多个小时。在服用了大量曲唑酮后，她终于睡着了，后来被诊断出患有四种不同的睡眠障碍，并得到了睡眠专家的成功治疗。在这里讨论这个案例，以提高对急诊医学专业健康状况不佳的认识，并提出解决这些多因素问题的实用方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JEM reports Emergency Medicine

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审稿时长

54 days