Alcohol withdrawal is not an uncommon presentation in our healthcare system. From patients making ER visits to get help for withdrawal symptoms to patients with a history of heavy or chronic alcohol use being admitted to medical and surgical units where they experience abrupt cessation of their alcohol consumption, it is important that physicians of all specialties be able to determine an individual's drinking history and risk of alcohol withdrawal, as well as be able to manage the withdrawal syndrome accordingly.
While the CIWA protocol is the tool we are most familiar with in terms of assessing a patient's withdrawal symptoms and guiding treatment with medications, in the last few years a new assessment tool has been developed as a way to help providers distinguish between those who are at risk of developing more "complicated" forms of withdrawal that require more intensive monitoring and management, and which are more highly associated with morbidity, mortality, and healthcare resources.
The tool is known as PAWSS "Prediction of Alcohol Withdrawal Severity Scale", and provides physicians with guidelines of both clinical investigations to order and questions to ask patients, to determine one's risk of experiencing severe withdrawal including seizures and delirium tremens. Based on current literature, it is thought that the scale is both highly sensitive and specific, when a score threshold of 4 is used.
To read more about the PAWSS tool, click here:
http://alcalc.oxfordjournals.org/content/50/5/509.long
While the CIWA protocol is the tool we are most familiar with in terms of assessing a patient's withdrawal symptoms and guiding treatment with medications, in the last few years a new assessment tool has been developed as a way to help providers distinguish between those who are at risk of developing more "complicated" forms of withdrawal that require more intensive monitoring and management, and which are more highly associated with morbidity, mortality, and healthcare resources.
The tool is known as PAWSS "Prediction of Alcohol Withdrawal Severity Scale", and provides physicians with guidelines of both clinical investigations to order and questions to ask patients, to determine one's risk of experiencing severe withdrawal including seizures and delirium tremens. Based on current literature, it is thought that the scale is both highly sensitive and specific, when a score threshold of 4 is used.
To read more about the PAWSS tool, click here:
http://alcalc.oxfordjournals.org/content/50/5/509.long
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