Withdrawal In The Emergency Department Essay

Assessing and Treating Alcohol Withdrawal in the Emergency Department: The Need for Standard Protocols. The emergency department (ED) has evolved to be more than a place to treat acute life-threatening illness and injuries; it has become a point of entry for care for a variety of clinical presentations. The reliance on emergency care remains strong with a rising numbers of patients accessing care. According to the American College of Emergency Physicians based on a report commissioned by the Emergency Medicine Action Fund, ED visits have increase substantially since the Affordable Care Act was enacted (American College of Emergency Physicians (ACEP), 2015). This trend has been recognized at Salem Hospital’s ED as well. An interview with the
The most commonly used scale is the clinical institute withdrawal assessment-alcohol, revised (CIWA-Ar). This 10-item, easily administered scale assesses and monitors the progression and severity of withdrawal symptoms. Additionally, this symptom-triggered regimen involves treatments tailored to the patient's individual needs, such as medication administration and reassessment time periods based on objective evidence collected by the clinician (Riddle, Bush, Tittle, & Dilkhush, 2010; Stehman, & Mycyk, 2013). The CIWA-Ar was first introduced in 1978 with the latest revision in 1989 (Sullivan, Sykoram, Schneiderman, Naranjo, & Sellers, 1989). The CIWA-Ar is a well validated tool and is still considered the gold standard for clinicians for assessing and treating symptoms of alcohol withdrawal (Sachdeva, Choudhary, & Chandra,
Patients are experiencing extended wait times and in increase in the overall length of stay. When considering the prevalence of alcohol use, the adverse effects of abruptly stopping habitual use and the increase in the length of stay in the emergency department, clinicians must have access to screening, assessment, and management tools for AWS. With minimal time and cost, PAWSS and the CIWA-Ar could be implemented in the ED. These tools for prompt identification and treatment of patients at risk for AWS have proven to be efficacious by a number of research studies as they increase the identification of people at risk for AWS thus reducing the delay in the care for these patients (Ng, Dahri, Chow, & Legal, 2011). In this fast-paced, protocol-driven unit, having access to quick and easy assessment and intervention tools will be beneficial to not only the clinician, but to the patients at risk for AWS as