Patient Assessment
On admission positive drug screen or Audit-C
Contact provider
Offer social work consult and Addiction Psych Consult
How often is CIWA assessment completed?
Every 4 hours
How often is a COWS assessment completed
Every 4 hours
Medication used most often at TMC for ETOH withdrawal
Phenobarbital
What does CIWA stand for
Clinical Institute Withdrawal Assessment
Common outcome when patients with Substance Use are not properly treated
AMA
Patient ordered for CIWA what non pharmaceutical corresponding order can be expected?
Telemetry monitoring
What is considered a moderate to severe withdrawal score on COWS assessment
Score > 12
Phenobarbital doses of up to 130 mg are administered as
IV Push
CIWA >15
Indicates severe withdrawal
When speaking with patients, take into consideration past events, also known as
Trauma Informed Care
CIWA assessments are used for patients with what type of withdrawal?
Etoh and Benzos
COWS assessments are done on patients who are withdrawing from?
Opioids
10 mg/kg and 5mg/kg are specific phenobarbital loading doses ordered by providers
Full or partial
How many symptoms are measured in the CIWA assessment?
10
Patients with substance use disorder often face unique challenges such as
SDOH; housing, food insecurity
Common medication paired with CIWA protocol
Phenobarbital
Common medications paired with COWS assessments
Methadone, Clonidine, Loperamide, Odanestron
Name 2 nutritional supplements included with treatment of ETOH
Thiamine, Folic Acid, Multivitamin
Left untreated, alcohol withdrawal can lead to
(name 2)
seizures, hallucinations, delirium tremens, heart attack or stroke
SUD patients with acute pain are often given ___________ doses of opioids that don't account for high tolerance
Sub-therapeutic
CIWA is not an appropriate tool when
Patient cannot reliably report symptoms
COWS assessments are more subjective or less subjective data driven
Less subjective
Patients ________________ receive a prescription for Phenobarbital to take home
Should not
Name 5 symptoms evaluated in CIWA assessment