Alcohol withdrawal assessment scale (CIWA-AR)
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Inpatient alcohol withdrawal management
Indications for inpatient management
Inpatient management is indicated if the person:
- has had a previous severe withdrawal
- has had previous seizures as a result of withdrawal
- has had previous delirium as a result of withdrawal
- has other physical health problems such as heart disease or severe liver disease
- has had several attempts at withdrawing at home unsuccessfully.
- Is dependent on several substances
- has unstable accommodation
- does not have access to an appropriate support person to monitor them and assist with medication administration.
The mainstays of alcohol withdrawal management remain:
- Regular monitoring and escalation of care should the withdrawal not be adequately controlled.
- Benzodiazepines to reduce withdrawal.
- Thiamine parenterally initially then oral to reduce the risk of Wernicke-Korsakoff's.
See the SA Health Guideline for the management of people at risk of alcohol withdrawal in acute hospitals for detailed advice. This guideline is for use across all SA Health hospitals.
Further information and advice
Alcohol and Drug Information Service (ADIS) 1300 13 1340
ADIS is a confidential telephone information, counselling, and referral service for people dealing with their own or another’s alcohol or drug problem. ADIS operates 8.30am to 10pm seven days per week.
Drug and Alcohol Clinical Advisory Service (DACAS) (08) 7087 1742
DACAS provides a telephone and email service for South Australian health professionals seeking clinical information and clarification around clinical procedures, guidelines and evidence-based practice.
Telephone: (08) 7087 1742 from 8:30am - 10pm 7 days/week including public holidays or e-mail your enquiry to: HealthDACASEnquiries@sa.gov.au.
DACAS is available 24/7 for urgent overnight matters to hospital consultants, registrars and general practitioners covering emergency departments in rural/remote settings.
This service does not provide proxy medical cover and cannot assume responsibility for direct patient care.
