Alcohol Protocol County Jails

I do not always know what someone has blown and the ER is quick to send them here. IM's are detoxed in holding cells or the bubble, cells surrounding the booking area. We put a green dot on their chart and co's do 15 min checks. The detox protocol is activated by assessment score. The order reads:

Tx. by assessment score only. Assessments bid-qid and PRN for 72 hours. Document on flow sheets.

E-kit is used to begin tx immediately if indicated by assessment score.

Increase fluids by 2 cups @ AM, PM, and HS.

Guidelines: Serax 15 mg one PO q 4-6 hours PRN x 72 hours for assessment scores 3-6. Serax 30 mg po q 4-6 PRN x 72 for assessment scores above 6.

In addition MVI 1 po qd x 5 days; Folic acid 800 mcg 1 po qd x 5 days; thiamine 250 mg 1 po qd x 5 days. Document all meds given on MAR.

Assessment scores are 1-3 based on behavior and severity of these:

BP, Temp, Pulse, Resp (are not scored but recorded), sweating, N/V, tremor, agitation, confusion. Call MD for additional orders if the following: hallucinations or convulsions. So it is eleven categories. The scoring is qualified for example Pulse 90-100 scores 1, 101-130 scores 2, >130 scores 3. Some of it is objective, some subjective so you use your meter. Vomiting should be witnessed. If you need more or this is confusing let me know.