Loss Lessons: Recognition of Wernicke Encephalopathy

Description

Wernicke encephalopathy (WE) is a syndrome, commonly seen in patients with alcohol use disorder who do not take adequate thiamine. A classic triad of symptoms features ataxia, ophthalmoplegia, confusion, and loss of short-term memory. The diagnosis can be elusive as there is not specific diagnostic marker for the condition. WE should be suspected in any patient with conditions that may lead to malnutrition in combination with any of the following symptoms: altered mental status ophthalmoplegia, ataxia, delirium, and hypotension. Considered a medical emergency, it must be reversed to prevent permanent deficits. This case illustrates a cascade of errors which led to permanent disability. Some practical interventions to quickly recognize and reverse the condition are offered following the case presentation.

Description of the Professional Practice Gap (PPG)

Knowledge gap related to the signs and symptoms and appropriate treatment of Wernicke Encephalopathy. It is a rare but serious medical emergency that requires prompt treatment. Diagnosis can be challenging and requires detailed patient history and clinical evaluation. There is not a specific test to detect it so clinicians must rely on the diagnostic process to rule out other disorders with similar presentations. This activity highlights some of the pitfalls and treatments.

Learning Outcome

Learners will know that Wernicke encephalopathy is an emergent condition that requires immediate treatment with high dose thiamine to prevent permanent neurological deficit or death as a result of this education.

Learning Objectives

After completing this activity, learners will be able to:

• Recognize the symptoms related to Wernicke encephalopathy when presented.
• Recognize that prompt treatment with high dose thiamine administered IV is required to avoid progression of the condition to permanent brain damage or death.
• Know that WE is underdiagnosed and under treated because the classic triad of symptoms confusion, oculomotor disorder, and ataxia may only be fully present in about 10 percent of patients.

Course Developers

Kimberly Hathaway, MSN, RN, CPHRM, CPHQ, Director Patient Safety Healthcare Quality & Risk Management, The Doctors Company
Amy Wasdin, RN, MBA, CPHRM, CPHQ, Director, Patient Safety Staff Education, The Doctors Company
Johanna Lackner, MPH, MSW, Senior Director, Continuing Professional Development, Department of Patient Safety and Risk Management, The Doctors Company

Continuing Education Credit

The Doctors Company is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical educational activities for physicians.

The Doctors Company designates this activity for a maximum of 0.5 AMA PRA Category 1 Credit™.  Physicians should claim only the credit commensurate with the extent of their participation in the activity.

No individual in a position to control or influence the content of this activity has reported relevant financial relationships with commercial interests. No commercial support was provided for this activity.

ANCC - Accreditation and Disclosure Statement

The Doctors Company is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation.

The Doctors Company designates this activity for a maximum of 0.5 nursing contact hour. Learners should claim only the credit commensurate with the extent of their participation in the activity.

No individual in a position to control or influence the content of this activity has reported relevant financial relationships with commercial interests. No commercial support was provided for this activity.
 

Disclaimer
This program is being offered for informational and educational purposes only from a Patient Safety Risk Management perspective and does not constitute legal advice. Laws vary from state to state, actual clinical situations often involve subtle differences and nuances from program scenarios or recommendations, and the recommendations provided in this activity may not apply to all practice situations. In complex circumstances, which present significant potential for an adverse event or litigation, TDC and the faculty recommend you consult directly with your corporate or personal counsel for professional legal guidance. 

Complies with State Requirements

Please SEE the Federation of State Medical Boards overview of Continuing Medical Education requirements by State. 
Please SEE the Registered Nurse and Licensed Practical Nurse CE Requirements by State.
 

Technical Requirements

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Contact Us

If you have questions, contact educationsupport@thedoctors.com or call 800.421.2368.

Resource

Visit our Resource document for this program.