alcohol withdrawal syndrome
The neurological, psychiatric, and cardiovascular signs and symptoms that result when a person accustomed to consuming large quantities of alcohol suddenly becomes abstinent. Alcohol withdrawal usually follows a predictable pattern. In the first hours of abstinence, patients are often irritable, anxious, tremulous, and easily startled. Their blood pressure and pulse rise, but they remain alert and oriented. If they do not consume alcohol (or receive drug treatment) in the first 12 to 48 hours, they may suffer an alcohol withdrawal seizure. Abstinence for 72 to 96 hours may result in severe agitation, hallucinations, and marked fluctuations in blood pressure and pulse. This stage of withdrawal is known as delirium tremens, or alcoholic delirium; it may prove fatal in as many as 15% of patients. SYN: alcohol withdrawal.
SEE: delirium tremens.
Patient Care: Benzodiazepines, e.g., chlordiazepoxide, are the preferred agents for managing alcohol withdrawal although other agents, e.g., carbamazepine, may be useful in treating mild cases. The patient should be comforted and reoriented as needed. Familiar objects and people may aid reality orientation. Every effort should be made to prevent unintentional injury; bedrails should be padded to protect against seizures and trauma, and patients should be protected from falling. Excessive stimulation of the patient should be avoided. Patients who are suffering delirium tremens are typically cared for in an Intensive Care Unit, where minute-to-minute monitoring of vitals signs and invasive management is readily available.