Addiction

What should be given to patients with impaired consciousness

100 mg or more of IV thiamine followed by IV glucose

When do manifestations of AWS start after last drink

Typically within 6 to 24 hours

When do AWS seizures typically start

8 to 24 hours after last drink

When do seizures typically peak after the last drink

24 to 48 hours later

% of patients that have only mild to moderate symptoms of AWS

90

When do DTs appear

72 to 96 hours after last drink

How long does delirium last for

2 to 3 days

CIWA-Ar score that is mild

8 or less

CIWA score considered moderate

11 to 15

CIWA score considered severe

Greater than 15

what should all patients presenting with AWS receive

IV thiamine followed by oral supplementation for several weeks

What other molecule should be evaluated for in patients with AWS?

Consider repleting phosphate stores

Evaluation of a patient with their first seizure

Neuro exam, brain imaging, plus or minus LP and EEG

• worried about meningitis or head trauma

How often does a second seizure occur

25 % of the time

How many components are in the CIWA?

10

What’s an easy grouping to use for the CIWA and how many categories are in each?

Body- 3

Mind- 2

Senses- 3

Brain- 2

Using the main categories from Before, which subcategories are in each of the 4 main CIWA?

Body

• Nausea

• Tremor

• Sweats

Mind

• anxiety

• Agitation

Senses

• tactile hallucinations

• Auditory hallucinations

• Visual hallucinations

Brain

• headache

• Orientation

Total CIWA score

67

• 0 to 7 on 9 categories

• O to 4 on orientation

Roughly, how is the CIWA scored

0- not present

1/2: mild

3/4: moderate

5/6: severe

7: constant severe

0- oriented