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Treatment
C. Hospitalized Patients
(1) Identification
Î Recommendation VII.10: All patients admitted to the hospital should
be screened for risk of alcohol withdrawal. Among hospitalized
patients, the Alcohol Use Disorders Identification Test (AUDIT) and
Alcohol Use Disorders Identification Test-Piccinelli Consumption
(AUDIT-PC) can indicate risk of developing alcohol withdrawal.
Î Recommendation VII.11: Patients undergoing elective surgery should
be screened for unhealthy alcohol use and the need to undergo alcohol
withdrawal management before proceeding with surgery. Patients
undergoing elective surgery who are at risk of alcohol withdrawal should
undergo medically managed withdrawal before proceeding with surgery.
(2) Assessment
Î Recommendation VII.12: Among hospitalized patients, the Prediction
of Alcohol Withdrawal Severity Scale (PAWSS) can be used for
predicting risk of developing severe or complicated alcohol withdrawal
in the medically ill.
Î Recommendation VII.13: For patients suspected of alcohol withdrawal
for whom a complete medical history is not available, (i.e., are
admitted from the Emergency Department or trauma unit, are in
Intensive Care Unit [ICU]), or who are known to be at high risk of
complicated alcohol withdrawal, medical decisions should be oriented
toward a more aggressive treatment of alcohol withdrawal regardless
of presenting signs and symptoms.
Î Recommendation VII.14: For patients who require more than standard
amounts of medication to manage alcohol withdrawal, individualized
assessment by clinicians experienced in the management of
withdrawal is recommended. The medication and protocol used for
treating other conditions and/or alcohol withdrawal syndrome may
need to be modified.
