Management of Delirium Tremens

Assessment and Diagnosis

• Assess for signs of alcohol withdrawal syndrome within 24 hours of hospitalization, including tremors, tachycardia, hypertension, sweating, anxiety, and potential progression to delirium tremens 1

Non-Pharmacological Interventions

• Ensure continuity of care by having the patient cared for by a familiar team of healthcare professionals 2
• Avoid moving patients between rooms or wards unless absolutely necessary 3
• Provide appropriate lighting and clear signage, ensuring that a clock and calendar are easily visible 3
• Talk to the patient to reorient them by explaining where they are, who they are, and what your role is 3
• Introduce cognitively stimulating activities and facilitate regular visits from family and friends 3

Monitoring and Follow-up

• Regularly reassess mental status using standardized tools like the Confusion Assessment Method (CAM) or CAM-ICU 2
• Adjust treatment approaches based on symptom control and patient distress 2

Common Pitfalls to Avoid

• Failing to provide thiamine supplementation to patients with alcohol use disorder 1
• Using antipsychotics as first-line treatment for alcohol withdrawal 1