BSG BASL Decompensated cirrhosis care bundle (British association for the study of the liver) 5 Evidence of Pabrinex prescribing in all 100% if the patient has a history of current excess alcohol consumption (>8 M or >6 F give IV – pabrinex (2 pairs of vials 3 times daily) patients who are current drinkers (if decompensated cirrhosis present) OR NICE CG100 Recommendations 1.2.1.1 offer thiamine to people at high risk of developing, or those are requiring detox OR if evidence with suspected, Wernicke’s encephalopathy. Thiamine should be given in doses toward the upper end of the National formulary’ range. of malnutrition. ‘British NICE CCG 100 recommendation 1.2.1.2 Offer prophylactic oral thiamine to harmful or dependant drinkers,, if they are malnourished or at risk of malnourishment or if they have decompensated liver disease or if they are in acute withdrawal or before and during a planned medically assisted alcohol withdrawal. NICE CG 100 recommendation 1.2.1.3 offer prophylactic parenteral thiamine followed by oral thiamine to harmful or dependant drinkers: if they are malnourished or at risk of malnourishment or if they have decompensated liver disease. in addition they attend an emergency department or are admitted to hospital with an acute illness or injury. Etc NICE cg 115 recommendation 1.2.2.5 All adults who misuse alcohol who are referred to – 6 100% specialist alcohol services should have a brief triage assessment to assess the need for Whether a medically assisted withdrawal regime was started and if appropriately urgent treatment including assisted withdrawal. NICE CG 100 recommendation 1.1.3.1 Offer pharmacotherapy to treat the symptoms of used e.g. identification and management. acute alcohol withdrawal as follows - consider offering a benzodiazepine or carbamazepine or Clomethiazole may be offered as an alternative . Disclaimer: It is your responsibility to check against Staffnet that this printout is the most recent version of this document.
5 Evidence of Pabrinex prescribing in all patients who are current drinkers (if decompensated cirrhosis present) OR those are requiring detox OR if evidence of malnutrition. 100% BSG BASL Decompensated cirrhosis care bundle (British association for the study of the liver) if the patient has a history of current excess alcohol consumption (>8 M or >6 F – give IV pabrinex (2 pairs of vials 3 times daily) NICE CG100 Recommendations 1.2.1.1 offer thiamine to people at high risk of developing, or with suspected, Wernicke’s encephalopathy. Thiamine should be given in doses toward the upper end of the ‘British National formulary’ range. NICE CCG 100 recommendation 1.2.1.2 Offer prophylactic oral thiamine to harmful or dependant drinkers,, if they are malnourished or at risk of malnourishment or if they have decompensated liver disease or if they are in acute withdrawal or before and during a planned medically assisted alcohol withdrawal. NICE CG 100 recommendation 1.2.1.3 offer prophylactic parenteral thiamine followed by oral thiamine to harmful or dependant drinkers: if they are malnourished or at risk of malnourishment or if they have decompensated liver disease. in addition they attend an emergency department or are admitted to hospital with an acute illness or injury. Etc 6 Whether a medically assisted withdrawal regime was started and if appropriately used e.g. identification and management. 100% NICE cg 115 – recommendation 1.2.2.5 All adults who misuse alcohol who are referred to specialist alcohol services should have a brief triage assessment to assess the need for urgent treatment including assisted withdrawal. NICE CG 100 recommendation 1.1.3.1 Offer pharmacotherapy to treat the symptoms of acute alcohol withdrawal as follows - consider offering a benzodiazepine or carbamazepine or Clomethiazole may be offered as an alternative . Disclaimer: It is your responsibility to check against Staffnet that this printout is the most recent version of this document.
ARLD%20Patient%20Identification%20and%20Treatment%20Toollkit%20v2.docx