Healthcare News & Insights

Keys to identifying alcohol withdrawal in patients

Your hospital’s clinical staff should be on the lookout for any hidden issues or conditions that can affect a patient’s recovery. One condition that can be hard to detect is alcohol withdrawal, in part because its symptoms mimic those of other illnesses. And if alcohol withdrawal is ignored or untreated, it can be severely harmful to patients. 

GettyImages-503700857Whether it’s a patient visiting the hospital because of an emergency or for a planned surgery, the effects of detoxing from alcohol can be dangerous if the person’s gone without drinking for an extended period of time.

Symptoms to watch for

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V), signs of alcohol withdrawal include:

  • generalized seizures (characterized by rhythmic, jerking movements, especially in limbs)
  • increased hand tremors
  • autonomic symptoms (e.g., sweating, “racing heart”)
  • nausea
  • vomiting
  • insomnia
  • psychomotor agitation (e.g., not able to stop moving, feeling physically restless)
  • anxiety, and
  • hallucinations (the rarest symptom of alcohol withdrawal).

According to a news brief from the ECRI Institute, alcohol withdrawal symptoms usually begin within eight hours of a patient’s last drink. They’ll peak between one and two days after a person last ingested alcohol, and they’ll last for up to five days.

Per the DSM-5, patients must be experiencing at least two of these symptoms, along with “significant distress or impairment in social, occupational or other important areas of functioning.” These issues must be directly related to a patient’s lack of alcohol intake, and they can’t be attributed to any other substances, conditions or illnesses.

Handling withdrawal

If alcohol withdrawal isn’t addressed quickly, patients’ health can take a severe turn for the worse.

To prevent this from happening, hospitals need to have specific guidelines in place to screen patients for alcohol abuse upon admission. Patients who are screened and show signs of alcohol abuse may require further attention from providers.

The earlier providers can determine whether a patient is at risk of going through alcohol withdrawal at the hospital, the sooner patients can receive the appropriate treatment. For some patients, this may mean transferring them to a detox unit. Other patients may have additional conditions that would make this unsafe, so they must be closely monitored and medicated appropriately as they experience withdrawal.

An article in American Nurse Today says that patients experiencing alcohol withdrawal should have their vital signs checked every one to four hours. They should also be regularly evaluated using the Clinical Institute Withdrawal Assessment for Alcohol Scale (CIWA-Ar) to determine the extent and severity of their withdrawal symptoms.

Discharge planning for these patients should include referrals to outside treatment centers or providers to specifically address their alcohol use disorder.

It’s important for hospitals to review their policies and protocols regarding alcohol withdrawal in patients, making sure there aren’t any gaps that could cause a patient suffering from withdrawal to fall through the cracks.

 

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