I researched a little more on PAWSS and I really like that it takes the patient’s history and current status into account. It seems simple to use because it adds up to 10 max score with >/= 4 placing the patient at high risk indicating a need for prophylaxis (Ohio State University). At my hospital we use the CIWA scoring and I agree that education is important in order to maximize its benefit. Often times some nurses are afraid to give multiple doses of Ativan as indicated, not realizing the requirements of a withdrawing patient. I like the idea of trying to prevent withdrawal symptoms before they have a chance to become worse.
Resource
The Ohio State University. (n.d.). Alcohol Withdrawal. Retrieved from https://evidencebasedpractice.osumc.edu/Documents/Guidelines/AlcoholWithdrawal.pdf
Hi Caitlin:
Like your topic, at my ER we get a lot of alcohol abuse patients. Once the patients goes into delirium Tremens (DT)they are not easy patients to handle. As you mention, most of them end up in ICU.
Some detox centers are using 3 drugs approved by the U.S. Food and Drug administration (FDA). Naltrexone is used to reduce cravings, Acamprosate for long-term withdrawal symptoms, and Disulfiram which makes you sick if you drink.
Great presentation! I have used CIWA extensively and I don’t feel like it is adequate and so much of the assessment is subjective. I haven’t heard of using phenobarbital but it makes so much sense. I looked at the website julopez posted and it was very helpful, though the case could be made that all withdrawing patients have some kind of liver compromise (though perhaps not in the failure category) that would put them at risk for respiratory compromise. That is why I would think that phenobarb protocol and monitoring would be preferred. I agree that zyprexa is great and in my experience it has worked better than haldol. Thank you for your presentation and project. I learned a lot!
I researched a little more on PAWSS and I really like that it takes the patient’s history and current status into account. It seems simple to use because it adds up to 10 max score with >/= 4 placing the patient at high risk indicating a need for prophylaxis (Ohio State University). At my hospital we use the CIWA scoring and I agree that education is important in order to maximize its benefit. Often times some nurses are afraid to give multiple doses of Ativan as indicated, not realizing the requirements of a withdrawing patient. I like the idea of trying to prevent withdrawal symptoms before they have a chance to become worse.
Resource
The Ohio State University. (n.d.). Alcohol Withdrawal. Retrieved from https://evidencebasedpractice.osumc.edu/Documents/Guidelines/AlcoholWithdrawal.pdf
Hi Caitlin:
Like your topic, at my ER we get a lot of alcohol abuse patients. Once the patients goes into delirium Tremens (DT)they are not easy patients to handle. As you mention, most of them end up in ICU.
Some detox centers are using 3 drugs approved by the U.S. Food and Drug administration (FDA). Naltrexone is used to reduce cravings, Acamprosate for long-term withdrawal symptoms, and Disulfiram which makes you sick if you drink.
https://americanaddictioncenters.org/withdrawal-timelines-treatments/alcohol/
Great presentation! I have used CIWA extensively and I don’t feel like it is adequate and so much of the assessment is subjective. I haven’t heard of using phenobarbital but it makes so much sense. I looked at the website julopez posted and it was very helpful, though the case could be made that all withdrawing patients have some kind of liver compromise (though perhaps not in the failure category) that would put them at risk for respiratory compromise. That is why I would think that phenobarb protocol and monitoring would be preferred. I agree that zyprexa is great and in my experience it has worked better than haldol. Thank you for your presentation and project. I learned a lot!