Failure to diagnose alcohol withdrawal symptom (AWS) can be medical malpractice that may cause severe injury or even death in some cases. The ECRI Institute is looking at options to better “Identify Alcohol Withdrawal Symptoms Early and Ease Patients’ Care”.
An estimated 20 % of the patients that are admitted in US hospitals show symptoms of alcohol abuse or dependence. Those that are admitted for alcohol poisoning and detoxification may be difficult to treat but their alcohol withdrawal symptoms will usually be properly diagnosed and addressed.
Patients at a higher higher risk to be misdiagnosed for alcohol withdrawal symptoms are those who are admitted for a different medical condition than alcohol intoxication or dependence.
According to American Nurse Today alcohol withdrawal symptoms usually start after 6 to 8 hours of non drinking, peaks after 24 to 48 hours and can last up to 5 days. If left untreated, the symptoms can be light or severe. Depending of the degree of dependence of the patient, they may sometimes result in death if untreated.
Light symptoms of withdrawal signs can be irritability, anxiety, loss of appetite, sweating, nausea and vomiting as well as headache. Some patients can experience visual and auditory hallucinations after two days. In more serious cases, sudden alcohol withdrawal may cause severe symptoms such as hyperactivity of the central nervous system and delirium tremens (DTs) as well as seizures. Studies show that an estimated 20% of patients showing these symptoms die because healthcare providers failed to timely diagnose and treat AWS.
Unfortunately, too many healthcare providers are not properly educated in recognizing AWS. Additionally hospitals have a tendency to neglect alcohol screening when admitting patients. Medial staff education and well defined screening protocols are key to avoid misdiagnosis of AWS. In a recent study entitled “Improving Outcomes for High-Risk Patients: Creating Timely Reports From the Electronic Health Record” , Dr Whitman and Dr Purvis, two Clinical Nurse Specialists at the University of Wisconsin Hospital and Clinics, Madison demonstrated that the “electronic health record system could be used to identify patients at highest risk for alcohol withdrawal syndrome”. However the ECRI Institute indicates that their own studies found that electronic records are prone to flaws and errors when dealing with AWS. They recommend that health care organizations meticulously test their protocol to ensure proper diagnosis.