Alcohol Withdrawal, CIWA

Case Description

Molly Maple is a 52 year old who came through the ER. She was found at home by family passed out. The family reports she drinks heavily and thinks she passed out drunk. She came to the ER alert and oriented x 3. She is ambulatory but stumbles occasionally. She does not use any assistive devices. She has a saline lock to the right forearm intact. She was admitted to the med surg unit for altered mental status.

She is at risk for falls and is a full code. No known allergies. She has a saline lock 20G to the right antecubital space with NS infusing @ 100ml/hr (excluding MH). A CIWA should be done q 4 hours. On initial presentation in the ED the patient CIWA score was 10. The previous nurse reports the patient being mildly agitated but improved from the start of her shift. She had one episode of vomiting early in the previous shift. Labs were drawn this morning and a CXR was done on the previous shift.

Learning Objectives

1. The learner will demonstrate ability to assess a patient with alcohol (ETOH) withdrawal
a. Demonstrates understanding of CIWA tool by recalling purpose and appropriate situation to use tool
b. Demonstrates appropriate assessment of patient with ETOH withdrawals with use of CIWA
c. Demonstrates patient centered care
d. Provides supportive environment for patient in withdrawals
2. Learner will demonstrate hand off communication using SBAR when providing updates to all treating providers
a. States appropriate clinical information when utilizing SBAR communication during handoff
b. Demonstrate the correct use of SBAR communication during handoff
c. Provides advocacy and patient centered care using SBAR communication during handoff
d. Provides patient centered care, serving as an advocate in SBAR communication during handoff
3. The learner will be able to demonstrate appropriate actions based on CIWA results and develop an interprofessional plan of care in conjunction with the treating provider.
a. Demonstrates knowledge of the CIWA protocol
b. Develop a interprofessional plan of care based on CIWA assessment
c. Provide compassionate, supportive care