Refeeding and Wernicke's: Keeping Patients Safe and RDNs Out of Court

Refeeding syndrome (RS), precipitated by consistent nutrient delivery to a malnourished patient, can lead to metabolic disarray, with potentially devastating consequences. Yet macronutrient "deficiency" rarely goes without micronutrient deficiency, particularly thiamine. Wernicke's encephalopathy (WE) is a severe neurological syndrome due to deficiency of thiamine that often goes underdiagnosed and undertreated.

Unfortunately, many clinicians are under the impression that WE is only seen in those with alcohol abuse, but many other patient populations are at risk. RS and WE often go hand in hand; court cases are made of this. It is no coincidence that there are attorneys who specialize in WE in the U.S. and that litigation is on the rise.

The RDN must not only recognize the patient at risk for RS, but at the same time, consider that Wernicke's may be close at hand and lead the medical team to intervene. Serious complications can be avoided with appropriate identification and intervention.

This session prepares the RDN to identify patients at risk for both RS and WE and provide practical tips for prevention and treatment in order to keep their patients safe, and the RDN out of court.

CPE Level: Level 2 (intermediate knowledge/experience)
CPEU: 1.0

Performance Indicators

• 10.5.2 Monitors and identifies factors affecting client/patient progress in meeting goals.
• 10.3.4 Selects interventions intended to resolve or improve nutrition diagnoses.
• 10.2.1 Selects valid and reliable tools to conduct comprehensive nutrition assessments.

Learning Objectives

• Identify patients at risk for refeeding syndrome (RS) and Wernicke’s encephalopathy (WE)
• Describe the pathophysiology behind RS and WE
• Outline steps to minimize or, better yet, prevent complications of both RS and WE

Moderator

• Christina Rollins

Speakers

• Steven Davis
• Carol Rees Parrish