MGH/McLean Residency Training Program in Psychiatry

Massachusetts General Hospital and McLean Hospital, Harvard Medical School

Edition Massachusetts General Hospital, 1999

PART 3 / CH 23

Alcohol Withdrawal Checklist

Blood Pressure

< 140/90 0 pt

140/90 – 158/98 1

160/100- 175/110 2

176/110 –199/110 3

> 200/110 4

Tremors

Inner shakes 0

Inner shakes &

fine tremor 1

Tremor on holding

objects 2

Visible tremors 3

Tremor preventing

ambulation 4

Anxiety

Mild/able to sit 0

Mood swings, freq.

purposeful activity 1

Easily agitated 2

Pacing/nightmares 3

Hallucination 4

Mental Status

Alert, Ox4 0

Forgets simple

instructions 1

Occ. forgets locale 2

Confused/ Ox2 3

Confused/ Ox1 4

Pulse

90 or less 0

91-100 1

101-120 2

121-139 3

140 and above 4

Nausea/Vomiting

Occ. nausea 0

Nausea, but eats

small amounts 1

Vomits x1 q shift 2

Vomits x 2 q shift 3

Unable to eat due to

neurological status 4

Diaphoresis

Occ. sweaty palms 0

Palms always wet 1

Areas of damp

clothes 2

Beads of sweat seen 3

Clothing soaked 4

Staging

< 4 points Stage 0

4-7 points Stage I

8-14 points Stage II

15-21 points Stage III

22 + Stage IV

source: Addiction Research Foundation Clinical Institute Withdrawal Assessment -Alcohol, revised (CIWA-Ar)

Alcohol Detoxification Protocol

A. In all patients

· Thiamine 100 mg IM x 1, then PO QD x 7 d

· MVI 1 PO QD, Folate 1 mg PO QD

· Check vital signs and staging q 4 hr x 24 hr

B. Proctor I protocol

day 1: Librium 50mg PO q2h PRN x24h; vitals q4h while awake.

day 2: give 75% of total day 1 dose, divided QID

day 3: give 50%, day 4 give 25%, day 5 D/C…

(use Serax 45mg PO q2h PRN x24h when liver disease is present)

C. Alternative protocol

· day 1: check vitals and staging (see chart) q4h;

PRN Stage I or greater (see chart), give either…

- Librium 25-50mg PO q 4-6 hr

- Valium 5-10mg PO q 4-6 hr

- Serax 15-45mg PO q 2-4 hr. (use if hepatic disease present)

· day 2: give 100% of total day 1 dose divided QID;

change vital signs and staging orders to q 6 hours, and monitor for PRN’s usage over the next 24 hrs.

- If none used, decrease benzodiazepine by 50% a day until d/c.

- If additional PRN’s needed, add the amount used to the scheduled amount, and give that amount in scheduled divided doses over the next 24 hr period.

D. Self-taper protocol (Diazepam front-loading)

· day 1: diazepam 5-10mg PO q20 minutes (less aggressive: 20mg PO q2h) until patient is sedated and no withdrawal signs are noted. Diazepam (and its active metabolite, nordiazepam) will self-taper over next 2-3d.

source: Gastfriend DR, Elman I, Solhkhah R (1998) Psychiatric Clinics of N America: Annual of Drug Therapy.