What are the special concerns in the treatment of delirium tremens (DTs)?

Updated: Nov 06, 2020
  • Author: Michael James Burns, MD, FACEP, FACP, FIDSA; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Special concerns in the treatment of alcohol withdrawal include the following:

  • Failure to consider the diagnosis of alcohol withdrawal syndrome in patients with altered mental status, abnormal vital signs, or single simple seizure

  • Failure to treat patients with severe alcohol withdrawal syndrome with adequate doses of benzodiazepines, because these patients may require extremely large doses of parenteral benzodiazepines

  • Making the assumption that all seizures in people with alcoholism are due to alcohol withdrawal without considering other causes of seizures, such as infection, hemorrhage, or trauma

  • Failure to exclude other etiologies of altered mental status in patients with suspected alcohol withdrawal

  • Failure to admit patients to the hospital with signs and symptoms of major withdrawal or delirium tremens (DTs)

  • Failure to diagnose such conditions as hypoglycemia and pancreatitis

  • Failure to administer thiamine in patients presenting with alcohol withdrawal

  • Failure to use adequate chemical sedation with use of physical restraints

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