CPCP: Predicting Alcohol Withdrawal Severity by Medical Student Noah Frydenlund

Well, it’s about time for another stellar Clinical Problems in Consultation Psychiatry (CPCP) by a medical student. This one is by Noah Frydenlund and he had a question about whether or not there is any way other than clinical assessment to predict which patients will undergo complicated alcohol withdrawal or even simple withdrawal. The issue is relevant to physician practice because occasionally benzodiazepines can be overused in the hospital, even exposing patients to the risk of intoxication delirium.

Noah even reviewed a previous CPCP done recently by one of the Family Medicine residents who rotated through the general hospital psychiatry service, Dr. Puja Toprani. He also found some evidence for potential biomarkers including platelet count and potassium level. Furthermore, he cited the relatively new Prediction of Alcohol Withdrawal Severity Scale (PAWSS) developed by Stanford University psychiatrist and past president of the American Delirium Society, Dr. Jose Maldonado, MD.

As always, what’s most important about the CPCP exercise is the opportunity to develop the habits and skills vital to becoming a doctor–regular reflection on one’s knowledge and skills and how to improve them in an ongoing effort to provide excellent patient care. Noah’s a great example of how that happens at Iowa. He dreams big and that’s what medicine needs.


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