So I am doing my capstone project for BSN on CIWA vs phenobarbital protocol for ETOH withdrawals. Since CIWA is symptom based and I find it to be a more subjective tool, alot of patients either become under or overmedicated on benzos. So I am writing about how phenobarbital should be used to prevent severe withdrawal symptoms and how the benefits outweigh CIWA.
Regarding pheno, can you administer this med on a general floor? I know it comes in PO, IV or IM. I work a cardiac floor and have many patients coming in for ETOH withdrawals and based on the CIWA, alot of the patients end up getting transferred to ICU. What happens once a patient is in ICU for ETOH withdrawal? Phenobarb IV is initiated? Is there a protocol/scale that you follow as your administering it? I am doing my research but need clarification on these questions that I cant seem to find.
What is your opinion?