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11/5/19 mt Severe Alcohol Withdrawal (MICU Pilot)
November 7, 2019
From: "Mickala M. Thompson" <mickala.thompson@hhsys.org>
To: "All Pharmacists" <grp_allpharm@hhsys.org>
Sent: Tuesday, November 5, 2019 9:29:02 PM
Subject: Severe Alcohol Withdrawal (MICU Pilot)
Pharmacists:
The Severe Alcohol Withdrawal (MICU Pilot) PowerPlan is now available in Cerner. It is restricted to MICU only (4NEM and 4MST). If this PowerPlan is ordered for a patient on any other unit, please contact the provider for an alternative. Note: The HOSP Acute Alcohol Withdrawal PowerPlans may be utilized housewide.
Please discontinue all prior sedative/hypnotics when verifying the Severe Alcohol Withdrawal (MICU Pilot) orders. The physician will select one of three available dose escalations, each consisting of eight benzodiazepine and four PHENobarbital orders. The protocol is a nurse-driven dose escalation of benzodiazepines (or PHENobarbital) q30min PRN that continues until a patient-specific effective dose is found.
At that time, the nurse should use the NURSE Severe Alcohol Withdrawal (MICU Pilot) plan to enter the effective dose of the selected benzodiazepine or PHENobarbital q4h PRN AND discontinue the Severe Alcohol Withdrawal (MICU Pilot) plan . Additionally, a pharmacist consult will populate to prompt pharmacists to contact the prescriber to discontinue any remaining IV PHENobarbital orders that remain when the patient transfers out of MICU.
Please contact me if you have any questions or concerns. Thank you.