Question

For Alcohol Withdrawal Syndrome

• What should be on alert for with this kind of patient?
• What are the important assessments to make?
• What complications may occur?
• What interventions will prevent complications?
• What to do if these complications occur?

Answer 1

Ans) The acute alcohol withdrawal syndrome may range from mild to physically dangerous, and may include symptoms such as irritability, anxiety, agitation, increased heart rate, high blood pressure, seizures and in rarer cases, delirium tremens.

- Every hour the patient experiences AWS signs or symptoms, complete the CIWA-Ar scale and obtain vital signs. Used to evaluate the patient's progress during alcohol withdrawal, the CIWA-Ar takes 5 to 10 minutes to complete.

- Complications of alcohol withdrawal delirium:

In cases of severe alcoholism or severe alcohol withdrawal, complications may arise that will need to be treated. These are typically associated with frequent heavy consumption of alcohol. Other conditions related to heavy drinking that may need to be treated include:

• Alcohol-related liver disease: This occurs after years of heavy drinking and results in scarring and cirrhosis of the liver. Treatment may include antibiotics, “water pills” to remove fluid build-up, and removal of fluid from your abdomen. Left untreated, alcoholic liver disease can cause liver cancer and kidney failure.

• Alcoholic cardiomyopathy: In alcoholic cardiomyopathy, the long-term use of alcohol leads to hear failure. Treatment may include reducing sodium intake, and prescribing beta-blockers and ACE inhibitors. A heart transplant may be needed if cardiomyopathy isn’t able to be effectively treated.

• Alcoholic neuropathy: Alcoholic neuropathy is damage to the nerves from excessive drinking. Symptoms can include numbness, tingling, painful sensations, and muscle problems. Treatment may rely on physical therapy and controlling symptoms. The nerve damage is normally permanent.

• Wernicke-Korsakoff syndrome: Wernicke-Korsakoff syndrome is a brain disorder tied to alcoholism. It often results in brain damage in the thalamus and hypothalamus, and permanent damage to the parts of the brain involved with memory. Vitamin B-1 can improve symptoms that include muscle problems, but memory loss is often permanent.

People with AWD are also at increased risk of:

• injuries from falling during a seizure
• injuring themselves or someone else while confused
• developing an irregular heartbeat.

Treatments for AWD may include:
• intravenous fluids.
• anticonvulsants to prevent or stop seizures.
• sedatives to calm agitation and treat anxiety.
• antipsychotic medications to prevent hallucinations.
• medication to reduce fever and body aches.
• treatment for other alcohol-related conditions.