A new study evaluated the number of medication administrations (surrogate for nursing time) for patients with severe alcohol withdrawal and found that patients who were treated with phenobarbital required fewer repeat medication administrations within the first 3 and 6h of ED arrival. Patients were included if they received at least 100mg diazepam or 260mg phenobarbital and approximately 30% had documented alcohol withdrawal delirium in the ED. There were no differences in safety outcomes or intubations. Patients who received phenobarbital were also less likely to require ICU admission.
Phenobarbital's impact on nursing time is an important consideration as we continue to experience delays, overcrowding and boarding in the emergency department.
References
Nguyen V, Rauschenbach A, Panning A, et al.Phenobarbital vs. Diazepam-Based Strategies for Treating Severe Alcohol Withdrawal Syndrome in the Emergency Department. JEM 2026;88: 193-203.