Table 1

Summary of recommendations

ProblemRecommendations
Screening toolsAUDIT
PAWSS
Ancillary services to considerSocial work
Addiction Medicine
Psychiatry/Psychiatry Nursing
Patients to receive empiric prophylaxis (in appropriate clinical context)History of complicated alcohol withdrawal (delirium tremens┬▒seizures)
Multiple prior episodes or long duration of alcohol use
Comorbid medical or surgical illness (including TBI)
Age >65 years
Autonomic hyperactivity on presentation
Physiologic dependence on benzodiazepines or barbiturates
Elevated alcohol level, MCV, or AST:ALT ratio on presentation
Method of surveillancemMINDS
Medications for primary preventionBenzodiazepines
Phenobarbital
Alternative medications for preventionClonidine
Gabapentin
Dexmedetomidine (adjunct to benzodiazepines)
Propofol (adjunct to benzodiazepines)
  • ALT, alanine transaminase; AST, aspartate transaminase; AUDIT, Alcohol Use Disorders Identification Test; MCV, mean corpuscular volume; mMINDS, modified Minnesota Detoxification Scale; PAWSS, Prediction of Alcohol Withdrawal Severity Scale; TBI, traumatic brain injury.