Breaking rules: what about ETOH for DTs? - page 2

Okay, somebody tell me why we don't give patients alcohol when they come in developing DTs? Why are ER patients forced through the benzo thing when (it seems) a bit of ETOH would stabilize them right... Read More

  1. by   MollyJ
    Originally posted by OrthoNutter
    MollyJ

    Just thought I'd clarify something....I'm talking about DT pts who don't hang around long enough to detox. I'm talking about pts brought in by the cops for creating a public disturbance. I'm talking about pts who tell you that "you can go get F'd, I don't have to be here" when you try to tell them that they are at risk of seizures and other complications if they are non-compliant.

    I'm not talking about people who genuinely want to kick the habit. I'm more than willing to help them if they are prepared to make a decent go of it. And if they fall off the wagon, I'll help them get back on it, providing they are still willing to try.

    It's those people who just couldn't give a rat's bum about detoxing and are only doing it because someone's forcing them to that are the waste of time. They have to want to do it for themselves.
    Perhaps this had been done, but your hospital needs to network with the local police department's jail health services folk. Protocols can be designed for detox on site for jailed prisoners; the person/nurse implementing the protocol needs to know who is NOT a good candidate for outpatient detox. Sometimes the type of hospitalization you describe here occurs because the police department is trying to limit it's liability with alcohol addicted clients. It is expensive for the police department and not a good use of a hospital bed (unless the patient has a significant other medical dx, then alcoholism is just a secondary dx).
  2. by   Ted
    Interesting. . .

    Many doctors who admit patients for, let's say, pneumonia, will order a beer or glass of wine tid to help prevent DT's. This is done quite often at my small rural hospital.

    That being said. . . the mental health system in the county where my happy little hospital resides is VERY POOR!! Wouldn't want a family member being suicidal or schizophrenic or deperessed or addicted to anything in this area. Even the doctors admit this.

    Ted
  3. by   Dotti Doyle
    There are fairly standard detox protocols using Librium, Valium, Aivan, Serax. Docs in your facility should adopt a protocol & use it. Are you still allowing patients to smoke in your facility? Why would you allow them to drink? If the patient is a known alcoholic, the detox orders should be part of the admitting orders. Don't wait for the patient to start hallucinating.
    A pretty basic assessment can be done on admission re: ETOH use - how much, how often, last use, vital signs, diaphoresis, tremors, a few other clues. This is NOT rocket science or brain surgery, but ETOH or benzo withdrawal is a life-threatening situation.

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