ED detection and management of alcohol withdrawal syndrome

May 2018
Lappin JM, Ayub MH, Rogers D, Morgan M, Kanyamibwa JY, Shakeshaft A. (2018). Routine screening and related interventions significantly improve the effectiveness of emergency department detection and management of alcohol withdrawal syndrome. EMA - Emergency Medicine Australasia. doi: 10.1111/1742-6723.12959

In a regional ED in Australia, a screening and triage tool for AWS was introduced to routine ED assessment for a 13 week period. Subjects were all presentations to ED aged 16 and above with relevant presenting problems during the pre‐intervention phase (1 January 2015–31 December 2016) and the post‐intervention phase (8 August 2016–4 November 2016). Key clinical care delivery elements related to AWS in patients presenting to ED were compared pre‐ and post‐intervention, namely proportion of presentations: (i) meeting criteria for AWS; (ii) receiving appropriate management for AWS; and (iii) with alcohol documentation in patient notes.

A total of 5.8% of total ED presentations in the post‐intervention phase and 4.5% in the pre‐intervention 1 year phase had relevant presenting problems. Compared to the 1 year pre‐intervention phase, post‐intervention showed: (i) a significant decrease in the number of presentations meeting criteria for AWS (χ2 = 6.56, P = 0.01); (ii) a significant increase in appropriate management of AWS (χ2 = 17.09, P < 0.001); and (iii) a significant increase in alcohol documentation in notes (χ2 = 13.29, P < 0.001).

Detection and appropriate management of AWS and documentation of alcohol use can be improved significantly through adoption of a brief screening and triage tool, and related interventions to increase awareness of alcohol‐related problems.