Assessment & Monitoring, ETOH+ (and some questions about Geodon)

[NursingAgainstdaOdds]

Does anyone have some good resources on assessment and monitoring of intoxicated patients? Like everybody, we have an extraordinary number of these types of patients, and I would like to brush-up my monitoring and documentation. We also have a lot of intoxicated and/or mentally ill patients who receive Geodon/Ativan, as we have a specific psych portion to our ER. I would like to be better at monitoring of patients who have received these drugs, as it is pretty standard fair for the out-of-control and violent patients.

Help, advice, resources would be greatly appreciated.

[hotshot12345]

We use the CIWA protocol for pt who are in withdrawal.

[NursingAgainstdaOdds]

Not speaking to a pt in withdrawal, though there is always that possibility, particularly when they end-up in the ED for 13 hours ... I am talking about a typical highly intoxicated pt who is being monitored in the ED. I also end-up having a lot of these patients dosed with Geodon/Ativan and have some confusion related to how those drugs affect the pt neurologically and what more I can include in my assessment and documentation.

[HikingNinja, BSN, MSN, DNP, RN, APRN, NP]

I treat sedated ETOH patients the same as unknown altered LOC patients. I try to do q15min checks. I include a pupillary exam and document it is consistent with the medications given, airway management, cardiac function, output, and of course vitals and GCS. I treat them as if they might have a head bleed because you just never do know. I've had several ETOH who have turned out to be head bleeds. As for the psych patients I do vitals, have they been offered food, safety protocols initiated or maintained, and mood/affect.

D