Table 1 Adapted pediatric alcohol withdrawal protocol
Objective | Intervention |
|---|---|
Environment | Quiet room, soothing environment, time and space orientation reminders (e.g., clocks, room number) |
Surveillance | Vital signs and neurological surveillance every 4 hours CIWA-Ar evaluation every 4 hours |
Diet | No restrictions, maintain good hydration |
Sleep | Melatonin 3–10 mg po at bedtime as needed |
Nausea | Ondansetron 8 mg every 8 hours as needed Pantoprazole 40 mg every day |
Nicotine replacement therapy | Nicotine patch, 7–21 mg daily as needed Nicotine gums (2–4 mg) or lozenges (1–2 mg) every 1–2 hours as needed |
Vitamin supplementation | Thiamine 100 mg three times daily for 1 week, then twice daily for 2 months Folic acid 1 mg every day |
Laboratory investigations | • Liver function tests • Coagulation panel • Complete blood count • Creatinine kinase dosage • Electrolyte dosage • Urine drug screening (variable according to center) • Blood alcohol level |
Paraclinical investigation | Electrocardiogram |
Fixed-dosage benzodiazepine taper with diazepam | • 10 mg four times daily on day 1 • 10 mg three times daily on day 2 • 10 mg twice daily on day 3 • 10 mg daily, at nighttime on day 4 and 5 |