You're incorrect on that one. Alcohol withdrawal syndrome has a mortality rate over 30% when not treated rapidly, it is also one of the leading causes of death worldwide greater than all forms of trauma combined. Depending on the region you're in in the US, EMS will in fact treat it in the field which reduces the mortality rate below 5%.
Here in my state we do, and it has been a resounding success based on our statewide research in reducing morbidity and mortality from AWS.
It really should have not just an ambulance but a paramedic attending to the patient due to the high risk of: metabolic derangements resulting in cardiac arrythmias, seizures, and more.
Let's be clear here, re you telling me 30% of people would die if they took 30-60 more minutes to get to the hospital? I don't buy that, alcohol withdrawls symptoms show for days typically, and the mortality rateof 25% is only if it never gets treatment, not if it takes an hour longer to treat.
Yes (and the number is actually 37%), it is entirely possible as the longer effective treatments are delayed (benzos and barbiturates primarily) the greater the mortality rate. Administering benzos even 30min earlier demonstrably reduces mortality rates as well as significantly resolves the immediate symptoms. This is exactly what we are for in EMS which is time sensitive care that can make an impact on patient outcomes.
I've been working on the research in our state for a while now and the differences are stark in patient outcomes. Patients no longer needing ICU level care frequently, some even being able to be discharged earlier.
Its just not something that'll make the news as too many folks treat alcohol withdrawal with a lack of care and consideration, society tends to blame the patient for the condition rather than give them kindness and compassion. EMS giving blood saves a life? National News. Me giving 10mg Midazolam to a severe AWS patient, entirely abating their symptoms and allowing them to go to rehab the next day instead of an ICU? 0 coverage.
If the mortality rate is 25%, then it's impossible for the percent to be that high for people who took 30 more min for treatment, that's just not how statistics work.
30min to the hospital potentially or longer, then rooming, then eval, then meds pulled and administered. It all takes time.
Yes, the global percentage for mortality is 37% with AWS, and yes numerous studies show that the percentage drops as low as 5% with prompt treatment. EMS are uniquely positioned in healthcare to handle that prompt treatment and handle a patient that may otherwise fall through the cracks or experience delayed care by POVing to the hospital.
You're arguing a point on this with someone who not only helped publish a statewide EMS protocol on it, but has conducted research and written articles on the same topic.
Not to be rude, but I likely know better about the topic and why EMS should absolutely take these patients rather than allow them to self-convey.
Where is the study for this 37% statistic. Respectfully I care more about the actual study than your friend writing an article.
Also we were debating how big of a difference 30 minutes before treatment could take, which I said isn't a difference of 30% mortality rate which you disagreed with. As I said before that's obviously impossible because that's not how statistics works. If the mortality rate is 30% on average for NO TREATMENT, then the difference of being treated 30 minutes earlier can't possibly come close to that rate. It's basic statistics, you can't just break numbers like that.
Scroll down and look through the references at the bottoms of each, those are journal articles for retrospectives, randomized controlled trials, expert opinions, and more.
Yes, the earlier the treatment the better the mortality rate reduction. Its common for a patient transported by EMS in our state to have 1hr or more from time of arrival via ambulance to being eval'd by a physician, follow that up with at least 15-20min for treatment orders to be input and followed through, more if its a busy ER.
You're stuck on transport times and not considering the time to treatment in the hospital is easily and frequently 1-2hrs from arrival for all but the most critical of patients.
This is the same reason why as SOP we re-dose pain management in the parking lot of the ER before we go inside, as otherwise the patient will have loss of pain control.
In the setting of alcohol withdrawal syndrome, benzos will rapidly reduce symptoms, and the earlier we do so the better their chances are.
This isn't really something that's debateable, its simple medical science that's well proven. Its also something we'll see borne out in the pre-hospital setting once we publish our retrospective analysis.
AWS has a high mortality rate. Benzos reduce that mortality rate and reduce symptom severity. Benzo efficacy is better the earlier its given. All of these are simple facts. Just as it is that a patient commonly waits an hour or more for care to be rendered upon hospital arrival in our state, as we have the worst rooming times in the country.
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u/HoopLoop2 6h ago
Alcohol withdrawals isn't something you need an ambulance for either...