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Alcohol withdrawal delirium — RCPSC EM MCQ

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HardPsychiatric emergenciesAlcohol withdrawal deliriumRCPSC EM

CTAS 1: A 51-year-old with alcohol use disorder is 72 hours from last drink. Vitals are T 38.2°C, HR 148, BP 184/104. He is disoriented, diaphoretic and seeing insects. CIWA is high despite repeated oral diazepam. Glucose and sodium are normal. What is the most appropriate initial management?

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Correct answer: C — Escalating benzodiazepines with thiamine, fluids and monitored admission

Delirium tremens requires aggressive benzodiazepine therapy, thiamine, supportive care, monitoring and evaluation for complications or alternative diagnoses.

Reference: Canadian addiction medicine emergency practice; CAEP substance-use resources