We are pleased to advise that deep linking capability, enabling users to directly download individual mobile toolkits, has now been released on the RDS mobile app. When you install the update, you will see that each toolkit has a small QR code icon the header area beside the search icon – see screenshot below. Clicking on this icon will open up a window with a full-size QR code and the alternative of a short URL for sharing with users. Instructions are provided.
You may need to actively install the update to install RDS app version 4.7.1 to see this improvement. Installing this update is also strongly recommended to get the full benefits of the new contingency arrangements – specifically, that if the RDS website should fail, you will still be able to download new mobile app toolkits.
To check your current RDS version, click on the three dots bottom right of the RDS app screen. This takes you to a “More” page where you will see the version number. To install latest updates:
On iPhones – go to the Apple store, click on your profile icon top right, scroll down to see the apps waiting to be updated and update the RDS app.
On Android phones – these can vary, but try going to the Google Play store, click on your profile icon top right, click on “Manage apps and device”, select and update the RDS app.
Please get in touch with ann.wales3@nhs.scot with any questions.
It is important to distinguish between alcohol dependence and harmful use/misuse in hospital patients.
Those who are dependent on alcohol are at risk of medical complications (see Alcohol Withdrawal section).
Dependence includes:
Alcohol withdrawal is a life-threatening medical emergency. There can be delay between stopping drinking and severe complications. Delirium tremens may appear after 48 – 72 hours and seizures after 24 – 48 hours.
Recognising dependence means that action can be taken early before patients start to withdraw or whilst the withdrawal is still mild.
Protocols differ by hospital - check your local guidelines.
General principles include:
Some hospitals use the CIWA protocol (see Resources below) to tailor benzodiazepine treatment and others use fixed regimes.
CIWA typically involves Diazepam. In liver failure, use Oxazepam or Lorazepam.
Utilise the alcohol liaison service to provide on-going support and relapse prevention options, especially on discharge. Remember to prescribe ongoing oral thiamine.
It is crucial to contact the pharmacy and the prescriber to confirm:
Opioid withdrawal might be uncomfortable, however, inappropriately prescribed opioids can be fatal.
Never prescribe without confirmation of the above information and objective evidence of opioid dependence using a drug screen and Clinical Opiate Withdrawal Scale (COWS) score (See Resources below). If you are unable to contact the pharmacist/prescriber, and you have a confirmed positive drug screen, treat withdrawals symptomatically e.g. Loperamide, Zopiclone. If in severe withdrawal, Dihydrocodeine can be prescribed - check your local guidelines and continue monitoring COWS.
Refer the person to your local community addiction service and consider discussion with drug liaison team if your hospital has access to this service.
Seek advice from local services for ongoing management - remember take home Naloxone kits, advice on needle exchange, local relapse prevention groups, BBV screening, contraception and STI testing.
MyPsych App
