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.
Effective assessment is key to successful treatment.
If there is a suspicion of alcohol misuse prior to admission a formal assessment of the patient’s alcohol use must be undertaken (The FAST tool can aid assessment).
Severity of Alcohol Dependence Questionnaire (SAD-Q) should be completed.
The completed SAD-Q will be filed in the patient’s care record and the score obtained will be entered on to the fixed dose Chlordiazepoxide regime.
NICE guidelines recommend the use of fixed or symptom triggered dosing regimens with either chlordiazepoxide or diazepam to manage alcohol withdrawal.
In GG&C mental health services, diazepam is the drug of choice using a fixed dose regime. For patients with known liver impairment, oxazepam is the benzodiazepine of choice. (see chart on page 3-5).
The starting dose chosen will depend on the SAD-Q obtained and the clinical judgement of the prescribing doctor.
Appropriate vitamin supplementation is essential to mitigate the risk of developing Wernicke’s encephalopathy or Korsakoff’s syndrome.
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Wernicke’s Encephalopathy is an acute illness, which may be precipitated by alcohol withdrawal and is often under treated or missed.
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Intramuscular Pabrinex (1 pair once daily for first 5 days) and oral thiamine should be given to all patients undergoing treatment for alcohol withdrawal.
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Pabrinex is contraindicated if the patient is known to have an allergy to any of the components of the product or a previous reaction is noted.
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Thiamine should be prescribed as 50mg four times a day, due to absorption saturation giving large doses less often will result in poorer absorption.
Thiamine should be continued indefinitely for those with a history of significant alcohol abuse and in individuals who continue to engage in problem drinking (chronic alcohol reduces thiamine absorption and these individuals are particularly at risk of developing alcohol-related brain damage).
To help with long term adherence to thiamine:
The patient’s blood pressure, pulse and temperature should be monitored at 4 hourly intervals throughout treatment with close observation for over sedation.
The patient should be medically reviewed as necessary during the course of treatment.
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