ICU SAQs · Toxicology
Alcohol withdrawal — the management
A CICM Second-Part SAQ on severe alcohol withdrawal — symptom-triggered benzodiazepine, EFNS thiamine, electrolytes, and exclusion of mimics.
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Prompt
A 55-year-old chronic drinker, admitted 48 hours ago, is now agitated, tremulous and hallucinating with a HR of 130 and a temperature of 38.5°C. Outline the management.
Question
A 55-year-old chronic drinker, admitted 48 hours ago, is now agitated, tremulous and hallucinating with a HR of 130 and a temperature of 38.5°C. Outline the management.
[1] [2]References8ShowHide
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- [2]Wood E, Albarqouni L, Tkachuk S, et al. Will This Hospitalized Patient Develop Severe Alcohol Withdrawal Syndrome?: The Rational Clinical Examination Systematic Review JAMA, 2018.PMID 30167704
- [3]Galvin R, Bråthen G, Ivashynka A, et al. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy Eur J Neurol, 2010.PMID 20642790
- [4]Mayo-Smith MF Pharmacological management of alcohol withdrawal. A meta-analysis and evidence-based practice guideline JAMA, 1997.PMID 9214531
- [5]Perry EC Inpatient management of acute alcohol withdrawal syndrome CNS Drugs, 2014.PMID 24781751
- [6]Schabelman E, Kuo D Glucose before thiamine for Wernicke encephalopathy: a literature review J Emerg Med, 2012.PMID 22104258
- [7]Airagnes G, Valter R, Ducoutumany G, et al. Magnesium in the treatment of alcohol withdrawal syndrome: a multicenter randomized controlled trial Alcohol Alcohol, 2023.PMID 37012631
- [8]Schmidt KJ, Doshi MR, Holzhausen JM, et al. Treatment of Severe Alcohol Withdrawal Ann Pharmacother, 2016.PMID 26861990