[BroncoSmoRN]

I work in a combined SICU/MICU. I was curious of how other hospitals delt with patients that are in the ICU for either OD or ETOH.Most of these patients are also suicidal. Do all ICU's take care of patients that are in DT's or are they taken care of on Step down units. These patients are not on Ventilators, some are suicidal and can't go to a psych facilty so we manage them until transfer. Just curious about how it works at other hospitals.

Thanks

[Michigan RN]

Just depends on the situation I guess. I've worked both stepdown and ICU and I've had patients with DTs. When I worked stepdown, I got a lot of ETOH/OD patients. It just depends on how the patient is doing.

[busyrnandmom]

Originally Posted by BroncoSmoRN

I work in a combined SICU/MICU. I was curious of how other hospitals delt with patients that are in the ICU for either OD or ETOH.Most of these patients are also suicidal. Do all ICU's take care of patients that are in DT's or are they taken care of on Step down units. These patients are not on Ventilators, some are suicidal and can't go to a psych facilty so we manage them until transfer. Just curious about how it works at other hospitals.

Thanks

Hey BroncoSmoRN I have taken care of patients in DT's even on a med surg unit in the past with an Addictionologist and also their PCP caring for them. At this facility, we just had a slightly smaller load, but not by much. We gave po and/or IVP Librium on a routine schedule and when the DT's worsen, we had prn orders. The Addictionologist's office was in very close proximity to the hospital and responded quickly in person if we had a problem. We did send them to a higher level of care, however, if they were suicidal or had a 1 on 1 with them which was difficult on a busy med-surg unit where we had up to 10 or 11 pts each. This facility did this in ''the good old days'' 16 or so yrs ago when we were able to use restraints for patient safety. Of course, we were quick to transfer to Step down or ICU if the patient became more combative or clinical picture worsens. I know that was a long time ago, but just wanted to give you my experience. Anne, RNC

[diveRN]

We've had ETOH withdrawals in the PCU and in ICU.

In our hospital, if they can be managed without sedation/paralyzing them, they usually go to PCU. If they need leather restraints and/or an ETT, then they go to ICU. Leathers are 1:1 until we norc 'em.

Had a male pt one time in 5 points, very hard core DTs, bouncing off the bed ... bam, bam, bam .. but was oriented enough to answer questions appropriately. With three of us at his bedside and in spite of the restraints, he managed to slip his foot under his foley tube and self-DC'd his cath with the balloon intact. Wasn't pretty. Bought himself a 3 way, bladder irrigation, an ETT, and 3 days on the vent.

Saw him 6 months later while grocery shopping, didn't recognize him since he'd cut his hair and was all cleaned up. Not a drink since the night before I got him.

Unit criteria depends on acuity.

[cardiacRN2006]

We see them all the time. We have orders where we can give up to 4mg of Ativan IVP Q1, so that's not something that can be done on a med surg unit. So they stay with us until they can take the librium or until they get to Q4hr dosing of the IVPs.