Alcohol Withdrawal

Question 1

Screening for alcohol use or abuse
should be part of any admission:
CAGE

Answer 1

Have you ever felt the need to
Cut down on
your drinking?
• Have you ever felt
Annoyed by someone
criticising your drinking?
• Have you ever felt
Guilty about your drinking?
• Have you ever felt the need for an
Eye
opener (a drink at the beginning of the day)?

One point for each yes- a score of two or more = a problem

Question 2

What is Wernicke’s

encephalopathy?

Answer 2

A syndrome related to
deficiency of thiamine, often coupled with acute
carbohydrate loading. (thiamine is needed for
carbohydrate metabolism). If left untreated may result into Korsakoff’s syndrome and even death.

Question 3

What is Korsakoff’s syndrome?

Answer 3

– when Wernicke’s encephalopathy is untreated
– Prolonged heavy use of alcohol (depletion of
/inability to produce thiamine)
– Severe malnutrition

Question 4

What is CIWA

Answer 4

CIWA is alcohol withdrawal assessment flowsheet.

Question 5

What are the symptoms of alcohol

withdrawal?

Answer 5

Anxiety, impaired appetite, elevated BP, can be confused, nausea, can have hallucinations, possible seizures, insomnia, sweating

Question 6

What is the most common reason to be admitted to hospital for alcohol withdrawal?

Answer 6

Seizures, as people usually hit their head

Question 7

What is hyperhidrosis?

Answer 7

Excessive sweating

Question 8

What medications do they give often for alcohol withdrawal?

Answer 8

Diazepam to decrease withdrawal affects

Question 9

What are the goals to reduce alcohol withdrawal?

Answer 9

Minimise progression to severe withdrawal
• Patient will be free from injury during
alcohol withdrawal.
• Eliminate risk of dehydration, electrolyte
and nutritional imbalance
• Decrease in tremors and psychomotor
activity.
• Least amount of trauma/discomfort during
withdrawal.

Question 10

Interventions for prevention

of injury for withdrawal:

Answer 10

• Create safe environment for the patient
• Assess level of physical and cognitive
function and address as required
• Remove environmental hazards
• Consider use of bed-rails / restraints.
• Monitor vital signs and CIWA 4 hourly
• Provide emotional support
• Seizure precaution: suction/ambu-bag nearby
for after seizure care.

Question 11

What are the symptoms of Wernike’s syndrome:

Answer 11

• - involuntary, jerky eye movements or paralysis of
muscles moving the eyes
• - poor balance, staggering gait or
inability to walk
• - drowsiness and confusion

Question 12

What are the symptoms of Korsakoffs?

Answer 12

Symptoms:
– Difficulty acquiring new information
– Change in personality
– Lack of insight
– Confabulation

Question 13

How do you manage the prevention of delirium for alchohol withdrawal?

Answer 13

Monitor neurological status (CIWA)
• Verbally acknowledge patient’s fears
• Keep patient informed about what is
happening
• Maintain well-lit environment (if tolerated
by patient).
• Reduce stimuli, i.e. remove pictures, t.v.
• Keep patient oriented re PPPT

Question 14

What is Thiamine and what happens when alcohol is consumed excessively?

Answer 14

Researchers and clinicians know that chronic abuse of alcohol may lead to a deficiency in thiamine (also known as Vitamin B1). This deficiency can wreak particular havoc on the brain, causing a wide spectrum of deficits in cognition, behavior, and motor coordination.

Question 15

Where is Thiamine found naturally?

Answer 15

BROWN RICE. Low vitamine B is called Berry Berry.