ASAM Pocket Guidelines and Patient Guide

Alcohol Withdrawal Management

ASAM Opioid Addiction Treatment GUIDELINES Apps and Pocket Guides brought to you courtesy of Guideline Central. Enjoy!

Issue link: https://eguideline.guidelinecentral.com/i/1254278

Contents of this Issue

Navigation

Page 20 of 45

21 V. Inpatient Management of Alcohol Withdrawal A. Monitoring Î Recommendation V.1: The following monitoring schedule is appropriate: • In patients with moderate to severe withdrawal or those requiring pharmacotherapy, re-assess every 1–4 hours for 24 hours, as clinically indicated. Once stabilized (e.g., CIWA-Ar score <10 for 24 hours), monitoring can be extended to every 4–8 hours for 24 hours, as clinically indicated. • Patients with mild withdrawal and low risk of complicated withdrawal may be observed for up to 36 hours, after which more severe withdrawal is unlikely to develop. Î Recommendation V.2: Monitor patients' vital signs, hydration, orientation, sleep, and emotional status including suicidal thoughts. Î Recommendation V.3: Monitor patients receiving pharmacotherapy for alcohol withdrawal for signs of over-sedation and respiratory depression. Î Recommendation V.4: Signs and symptoms of alcohol withdrawal should be monitored during withdrawal management with a validated assessment scale (see Alcohol Withdrawal Scales Table for a summary of scales and their associated features). B. Supportive Care Î Recommendation V.5: Supportive care is a critical component of alcohol withdrawal management. Frequent reassurance, re-orientation to time and place, and nursing care are recommended non- pharmacological interventions. Providers should ensure patients are educated about what to expect over the course of withdrawal, including common signs and symptoms and how they will be treated. Patients with severe alcohol withdrawal should be cared for in an evenly lit, quiet room. Patients should be offered hope and the expectation of recovery. Î Recommendation V.6: Supportive care for alcohol withdrawal patients includes adherence to safety measures and protocols (e.g., assess risk for fall/syncope). If available and applicable, existing institutional/ hospital-associated delirium protocols can be used for supportive care of patients with severe alcohol withdrawal. Treatment – Inpatient

Articles in this issue

view archives of ASAM Pocket Guidelines and Patient Guide - Alcohol Withdrawal Management