Management of alcohol withdrawal in critically ill patients is a challenge. The alcohol consumption histories of intensive care patients are often incomplete, limiting identification of patients with alcohol use disorders. Abrupt cessation of alcohol places these patients at risk for alcohol withdrawal syndrome. Typically benzodiazepines are used as first-line therapy to manage alcohol withdrawal. However, if patients progress to more severe withdrawal or delirium tremens, extra adjunctive medications in addition to benzodiazepines may be required. Sedation and mechanical ventilation may also be necessary. Withdrawal assessment scales such as the Clinical Institute of Withdrawal Assessment are of limited use in these patients. Instead, general sedation-agitation scales and delirium detection tools have been used. The important facets of care are the rapid identification of at-risk patients through histories of alcohol consumption, management with combination therapies, and ongoing diligent assessment and evaluation. (Critical Care Nurse. 2016;36:28–39)
Feature| February 01 2016
Alcohol Withdrawal Syndrome in Critically Ill Patients: Identification, Assessment, and Management
Lynsey J. Sutton, RN, MNclin;
Lynsey Sutton is an associate charge nurse manager of a level 3 intensive care unit, Capital and Coast District Health Board, Wellington Regional Hospital, Riddiford, Wellington, New Zealand. She is a guest teaching assistant in the postgraduate nursing program at Victoria University of Wellington, New Zealand.
Corresponding author: Lynsey J. Sutton, ICU, Level 3, Capital and Coast District Health Board, Wellington Regional Hospital, Riddiford Street, Private Bag 7902, Wellington, NZ (e-mail: firstname.lastname@example.org).
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Crit Care Nurse (2016) 36 (1): 28–38.
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Lynsey J. Sutton, Annemarie Jutel; Alcohol Withdrawal Syndrome in Critically Ill Patients: Identification, Assessment, and Management. Crit Care Nurse 1 February 2016; 36 (1): 28–38. doi: https://doi.org/10.4037/ccn2016420
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