Alcohol Withdrawal: Symptoms, Treatments, Duration, and More #alcohol #withdrawal, #alcohol #withdrawal


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Alcohol Withdrawal

Alcohol withdrawal syndrome is a potentially life-threatening condition that can occur in people who have been drinking heavily for weeks, months, or years and then either stop or significantly reduce their alcohol consumption.

Alcohol withdrawal symptoms can begin as early as two hours after the last drink, persist for weeks, and range from mild anxiety and shakiness to severe complications, such as seizures and delirium tremens (also called DTs). The death rate from DTs — which are characterized by confusion, rapid heartbeat, and fever — is estimated to range from 1% to 5%.

Because alcohol withdrawal symptoms can rapidly worsen, it’s important to seek medical attention even if symptoms are seemingly mild. Appropriate alcohol withdrawal treatments can reduce the risk of developing withdrawal seizures or DTs.

It’s especially important to see a doctor if you’ve experienced previous alcohol withdrawal episodes or if you have other health conditions such as infections, heart disease. lung disease. or a history of seizures.

Severe alcohol withdrawal symptoms are a medical emergency. If seizures, fever, severe confusion, hallucinations. or irregular heartbeats occur, either take the patient to an emergency room or call 911.

Causes of Alcohol Withdrawal Syndrome

Heavy, prolonged drinking — especially excessive daily drinking — disrupts the brain ‘s neurotransmitters, the brain chemicals that transmit messages.

For example, alcohol initially enhances the effect of GABA, the neurotransmitter which produces feelings of relaxation and calm. But chronic alcohol consumption eventually suppresses GABA activity so that more and more alcohol is required to produce the desired effects, a phenomenon known as tolerance.

Chronic alcohol consumption also suppresses the activity of glutamate, the neurotransmitter which produces feelings of excitability. To maintain equilibrium, the glutamate system responds by functioning at a far higher level than it does in moderate drinkers and nondrinkers.

When heavy drinkers suddenly stop or significantly reduce their alcohol consumption, the neurotransmitters previously suppressed by alcohol are no longer suppressed. They rebound, resulting in a phenomenon known as brain hyperexcitability. So, the effects associated with alcohol withdrawal — anxiety. irritability, agitation, tremors, seizures, and DTs — are the opposite of those associated with alcohol consumption.

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Symptoms of Alcohol Withdrawal Syndrome

In general, how severe alcohol withdrawal symptoms become depends on how much and for how long a person has been drinking.

Minor alcohol withdrawal symptoms often appear 6 to 12 hours after a person stops drinking. Sometimes a person will still have a measurable blood alcohol level when symptoms start. These symptoms include:

Between 12 and 24 hours after they stop drinking, some patients may experience visual, auditory, or tactile hallucinations. These usually end within 48 hours. Although this condition is called alcoholic hallucinosis, it’s not the same as the hallucinations associated with DTs. Most patients are aware that the unusual sensations aren’t real.

Withdrawal seizures usually first strike between 24 and 48 hours after someone stops drinking, although they can appear as early as 2 hours after drinking stops. The risk of seizures is especially high in patients who previously have undergone multiple detoxifications.

DTs usually begin between 48 and 72 hours after drinking has stopped, Risk factors for DTs include a history of withdrawal seizures or DTs, acute medical illness, abnormal liver function, and older age.

Symptoms of DTs, which usually peak at 5 days, include:

  • Disorientation, confusion, and severe anxiety
  • Hallucinations (primarily visual) which cannot be distinguished from reality
  • Profuse sweating
  • Seizures
  • High blood pressure
  • Racing and irregular heartbeat
  • Severe tremors
  • Low-grade fever

Assessment of Alcohol Withdrawal Syndrome

If alcohol withdrawal syndrome is suspected, your doctor will take a complete medical history and ask how much you drink, how long you’ve been drinking, and how much time has elapsed since your last drink. He or she also will want to know if you have a history of alcohol withdrawal, if you abuse any other substances, and if you have any medical or psychiatric conditions.

During a physical exam. your doctor will identify alcohol withdrawal symptoms and any potential complicating medical conditions such as irregular heartbeats, congestive heart failure. coronary artery disease. gastrointestinal bleeding, infections, liver disease, nervous system impairment, and pancreatitis. He or she also may order blood tests to measure complete blood count. alcohol and electrolyte levels, liver function. and a urine screen to identify drug use.

The results of the medical history and physical exam will help your doctor decide if you have alcohol withdrawal syndrome and, if so, its severity.

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Treatment of Alcohol Withdrawal Syndrome

If you have mild to moderate withdrawal symptoms, your doctor may prefer to treat you in an outpatient setting, especially if you have supportive family and friends. Outpatient detoxification is safe, effective, and less costly than inpatient detoxification at a hospital or other facility.

However, you may require inpatient treatment if you don’t have a reliable social network, are pregnant. or have a history of any of the following:

  • Severe withdrawal symptoms
  • Withdrawal seizures or DTs
  • Multiple previous detoxifications
  • Certain medical or psychiatric illnesses

The goals of treatment are threefold: reducing immediate withdrawal symptoms, preventing complications, and beginning long-term therapy to promote alcohol abstinence.

Prescription drugs of choice include benzodiazepines, such as diazepam (Valium ), chlordiazepoxide (Librium ), lorazepam (Ativan ), and oxazepam (Serax ). Such medications can help control the shakiness, anxiety, and confusion associated with alcohol withdrawal and reduce the risk of withdrawal seizures and DTs. In patients with mild to moderate symptoms, the anticonvulsant drug carbamazepine (Tegretol ) may be an effective alternative to benzodiazepines, because it is not sedating and has low potential for abuse.

To help manage withdrawal complications, your doctor may consider adding other drugs to a benzodiazepine regimen. These may include:

  • An antipsychotic drug, which can help relieve agitation and hallucinations
  • A beta-blocker, which may help curb a fast heart rate and elevated blood pressure related to withdrawal and reduce the strain of alcohol withdrawal in people with coronary artery disease
  • Clonidine (Catapres ), another blood pressure drug
  • Phenytoin (Dilantin ), an anticonvulsant which doesn’t treat withdrawal seizures but may be useful in people with an underlying seizure disorder

Preventing Future Alcohol Withdrawal Episodes

Because successful treatment of alcohol withdrawal syndrome doesn’t address the underlying disease of addiction, it should be followed by treatment for alcohol abuse or alcohol dependence.

Relatively brief outpatient interventions can be effective for alcohol abuse, but more intensive therapy may be required for alcohol dependence. If you have alcohol dependence, your doctor may prescribe other medications to help you stop drinking. He or she also may recommend joining a 12-step group — such as Alcoholics Anonymous and Narcotics Anonymous — or staying at a comprehensive treatment facility that offers a combination of a 12-step model, cognitive-behavioral therapy, and family therapy.

WebMD Medical Reference Reviewed by Carol DerSarkissian on February 09, 2017

Sources

SOURCES:
National Institute on Alcohol Abuse and Alcoholism.
FamilyDoctor.org: “Alcohol Withdrawal Syndrome.”
Bayard, M. American Family Physician. March 15, 2004.

© 2017 WebMD, LLC. All rights reserved.


20/09/2017

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Find Water Leaks with Thermal Imaging, Acoustics and Tracer Gas #water


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Leak Detecting Services

How to Find a Water Leak

Our highly trained engineers at L.D.S. Leak Detection Specialists Ltd. will choose the approriate testing and inspection process specifically chosen to suit your home or commercial business to find the leak.

Our engineers at L.D.S. carry all the latest technology in leakage detection. We have listed the main Leak detection methods and equipment below. Inspection cameras. Protimeter mms damp meter survey kits, pressure gauges both hydraulic and digital and salts diagnostic kits also form part of the L.D.S. engineers equipment.

Leak Detection Methods to Find A Leak

Acoustics
Acoustic profiling uses ground and pipe sensitive microphones to enhance the sound of the leak. This method can help in pinpointing precise leak location.

Correlation
Is a way of finding and pinpointing leaks in water pipes. A leak in a pipe under pressure creates noise that travels through the pipe walls, the surrounding ground and along the contents of the pipe. Correlators are a very accurate sound testing device which are used to identify the acoustic frequency caused when a pipe is leaking. The correlator uses two identical sensors located along the pipe to calculate the leek location by logging the signal delay, sensor distance and the sound velocity.

Tracer Gas
The trace gas, a safe mixture of hydrogen and nitrogen, is introduced into the pipe with the suspected leak. The gas, is the lightest in the atmosphere and is made up of of small molecules. The gas will exit at the leak and make its way to the surface where it is detected using gas sensitive detection pobes.

Thermal Imaging
Thermography is the use of an infrared imaging and measurement camera to see and measure thermal energy emitted from an object. Thermography cameras can identify problem areas that can’t be seen with the naked eye, detecting hidden water leaks. The infrared inspection camera can detect not only hidden water leaks and their origin, but also moisture that cannot be physically reached with moisture meters. Read more

Pipe, Cable and Metal Detection and Tracing
Often the exact position of pipes and cables is unknown due to innacurate or non existant network plans. In order to carry out precise water leak detection and to avoid damage to utilities and operators during excavations, it is essential to know the precise position of all services. We use high performance equipment which can locate and trace buried pipes and cables.

Network Monitoring with Noise Loggers
Noise Loggers are used for early detection of leaks in water supply networks.The longer it takes to identify that a network is leaking the more revenue is lost and the greater the loss of precious water resources. In addition to the more conventional methods of leak detection the installation of permanent noise loggers has proved to be a cost effective tool in early identification of water loss. By permanently monitoring sections of the system, which have previously been proven leak free, it will alert you when a potential leak does develop. Read more .

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14/09/2017

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Judy Waterlow, Waterlow Score, Pressure Ulcer Care and Pressure Ulcer Risk


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Pressure Ulcer Risk Assessment and Prevention

Judy Waterlow MBE, now in her seventies, designed and researched her pressure ulcer risk assessment tool in 1985, while working as a Clinical Nurse Teacher. The tool was originally designed for use by her students.

Judy officially retired on medical grounds in 1988, due to the increasing severity of her rheumatoid arthritis, she has continued her efforts to improve nurse education and patient care with her work for the Tissue Viability Society, serving on the Committee and organising the TVS Regional Study Days for 13 years, Challenging Arthritis, the NHS Expert Patient Programme and latterly as a Musgrove Hospital Partner. The Partners are a group of unpaid volunteers who work with hospital staff in various ways within the hospital, where their personal expertise and experience can be of value.

This dedication to her profession both in hospital and in the community was recognised by the award of the MBE in the Queen s Birthday Honours list published on June 14th 2008.


(Photograph by Lucy Carlier posted with the permission of The British Journal of Nursing.)

At a glittering Awards Ceremony hosted by the British Journal of Nursing in London on 22nd March 2013 Judy was awarded a Special Award for her services to nursing. Unfortunately Judy s poor health precluded her attendance, so the award was collected by her 2 daughters Fiona and Sarah which was presented by Esther Rantzen.

If you would like a free download of a Waterlow Card please
Click here – Waterlow Score Card .

Free Waterlow Score Iphone App

If you would like a free download of a Waterlow Score Iphone App please Click here – Waterlow Score App .

The Waterlow Manual (Revised 2005)

If you wish to obtain a copy of Judy s Pressure Ulcer Prevention Manual there are two options to choose from:

Hard Copy Manual

Click here to print off an order form to send for a hard copy version of the Manual.

The main aim of this website is to provide easy access to up to date infomation on improving – pressure care. preventing pressure ulcers. and and the importance of risk assessment. plus information on the Waterlow Scale and how to use it effectively.

The site is primarily aimed at nurses, healthcare professionals, students, care home owners,and anywone interested in pressure ulcer care prevention.


06/08/2017

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