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Old 07-02-2011
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Arrow CCS- Alcohol withdrawl

ER:
Heald elevation
Pulse oximetry
Oxygen
IV access
Cardiac monitor
Aspiration precaution
Finger stick glucose
Thiamine IM one dose
Naloxone one dose
Destrose D5W
Folic acid one dose

.................................................. ...................

Physical exam: General/HEENT, Skin, Lungs, heart, Abdomen, extremities, Neuro psychatric.
One PE you can see some sign of Alcohol withdrawal.

CBC
BMP
Mg serum
Ph serum
LFT
Blood culture in infections suspected
Blood alcohol level
Amylase/
LDH serum
UA
Urine toxicology screen
Phenergen IV one dose
Lorazepam IV continue
After confirming the tests, see the report time. Advance the clock for 30 minute:
Check interval history
Now you are sure that he has Alcohol withdrawal symptoms.
.................................................. ........

Move the patient to ICU:
Best rest complete
NPO
IV saline
Vitals q6
Urine output
Foley catheter
Chlordiazepoxide oral continues
Haloperidol IV one dose if agitated
Elevate the head end of the patient
Compression stocking
Omeprazole IV continues
Phosphate IV
Magnesium IV
Advance clock for 8 hours
Interval history
Patient is now feeling better
.................................................. ................................

Now shift to ward:
d/c NPO
d/c Saline
Normal diet
D/c medications

Continue the same management. Advance the clock for another 8 hours.
Patient much better and 5 min screen pop up

.................................................. .................

Reassurance
Avoid illegal drugs
Stop alcohol
Stop smoking
Exercise
Diet Normal
Seat belt
Educate patient/family
Safe sex
Pneuococcal vaccine
Influenza vaccine
Multivitamin
Folic acid
Iron sulfate
Colonoscopy
PSA
Alcohol rehabilitation
Group therapy
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The above post was thanked by:
hionlyf (07-31-2012)



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Internal-Medicine-, Psychiatry-, Step-3-Questions, Toxicology-

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