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 will prepare 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.

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

Performance Indicators

10.2 Conducts a nutrition assessment to establish nutrition diagnoses, prescriptions, and care plans

10.3 Establishes and implements evidence-based nutrition interventions to address PES statements and client/patient goals

10.5 Monitors nutrition care plans to ensure individual health goals are achieved


Steven Davis


Davis & Davis, Attorneys at Law

Carol Rees Parrish

GI Nutrition Support Specialist

Self-employed now


Stephanie Dobak

Clinical DIetitian III

Jefferson Weinberg ALS Center

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