• Julia M Lappin, Muhammad H Ayub, David Rogers, Madeleine Morgan, Jean-Yves Kanyamibwa, and Anthony Shakeshaft.
• National Drug and Alcohol Research Centre, The University of New South Wales, Sydney, New South Wales, Australia.
• Emerg Med Australas. 2018 Oct 1; 30 (5): 648-653.

ObjectiveTo evaluate the effectiveness of a routine screening and triage tool for alcohol withdrawal syndrome (AWS) in improving clinical care delivery in an ED setting.MethodsIn a regional ED in Australia, a screening and triage tool for AWS was introduced to routine ED assessment for a 13 week period. Subjects were all presentations to ED aged 16 and above with relevant presenting problems during the pre-intervention phase (1 January 2015-31 December 2016) and the post-intervention phase (8 August 2016-4 November 2016). Key clinical care delivery elements related to AWS in patients presenting to ED were compared pre- and post-intervention, namely proportion of presentations: (i) meeting criteria for AWS; (ii) receiving appropriate management for AWS; and (iii) with alcohol documentation in patient notes.ResultsA total of 5.8% of total ED presentations in the post-intervention phase and 4.5% in the pre-intervention 1 year phase had relevant presenting problems. Compared to the 1 year pre-intervention phase, post-intervention showed: (i) a significant decrease in the number of presentations meeting criteria for AWS (χ2 = 6.56, P = 0.01); (ii) a significant increase in appropriate management of AWS (χ2 = 17.09, P < 0.001); and (iii) a significant increase in alcohol documentation in notes (χ2 = 13.29, P < 0.001).ConclusionsDetection and appropriate management of AWS and documentation of alcohol use can be improved significantly through adoption of a brief screening and triage tool, and related interventions to increase awareness of alcohol-related problems.© 2018 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

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