NOTE: Indications of Fiellin et al for detoxification of an alcoholic as an inpatient are listed in 32.16.13. Some of these criteria overlap with those but some are more specific.
Criteria for referral to a specialist or for inpatient detoxification:
(1) confusion
(2) hallucinations
(3) seizures or history of seizures
(4) risk of suicide
(5) acute psychiatric illness
(6) acute comorbid medical illness (see signs of adult beri-beri in #10)
(7) failed home detoxification
(8) malnutrition
(9) unsupportive home environment
(10) Wernicke's encephalopathy (or other signs of adult beri-beri from 12.01.15: heart failure, lactic acidosis, cyanosis, peripheral or pulmonary edema, renal failure)
Signs of Wernicke's encephalopathy may include:
(1) confusion and delirium
(2) cerebellar ataxia
(3) ophthalmoplegia and/or nystagmus
(4) coma
(5) hypotension
(6) hypothermia
(7) unexplained neurologic findings
(8) irritable and forgetful
