Alcohol Withdrawal Syndrome (AWS) - ICU OnePager
Scoring Alcohol Withdrawal Syndrome (AWS):
• PAWSS
• CIWA-Ar
• AWS
Withdrawal Symptom Timeline:
• Minor Withdrawal Symptoms (6-36 hours):
- Tremulousness, anxiety, h/a, diaphoresis, palpitations, N/V, w/ normal mentation
• Withdrawal Seizures (6-48 hours)
- 1-3 usually generalized seizures
- Status epilepticus occurs in 3%
- High risk of progression to DTs
• Alcoholic Hallucinosis (12-48h):
- Visual, auditory, & tactile hallucinations, with intact orientation & normal sensorium with normal vital signs
• Delirium Tremens (48-96h)
- Fluctuating cognition & attention, altered sensorium (hallucinations)
- Autonomic instability (low grade fever, tachycardia, hypertension, diaphoresis)
Treatment:
• Benzodiazepines
• Barbituates
• Propofol
• Dexmedetomidine
• Clonidine
• Haloperidol
• Baclofen & Ketamine
by Nick Mark MD @nickmmark and Mark Ramzy, DO @MRamzyDO
#Alcohol #Withdrawal #Syndrome #AWS #diagnosis #treatment #management #etoh #timeline
