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by mwattum mwattum (New) New Nurse

Specializes in Critical Care. Has 8 years experience.

First post, yay!

I work for a medicine critical care unit for a large teaching hospital, and I see a fair share of patients going through complicated alcohol withdrawal. We use the standard CIWA protocol and administer PRN Lorazepam/Diazepam based on the CIWA score, and sometimes the providers will order a scheduled fixed dose, most frequently q6hrs, on top of the PRN's.
I have been reading a lot of benefits of Phenobarbital lately. And I wanted to hear other RN's experience with this medication. And I also was wondering what protocol do you use to administer it? From what I have read it seems like its often ordered PRN q30min. Do you administer it based on CIWA? RASS? Do you often do a loading dose? Any experience administering it PO for these patients. It this medications usually used in patients have symptoms refractory to Diazepam/Lorazepam, or do you see a benefit to administering this medications early on in the withdrawal process?
Also, do you see this medication administered outside of the ICU?

Thank you!