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Delirium tremens — RCPSC EM MCQ

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HardPsychiatric emergenciesDelirium tremensRCPSC EM

A 47-year-old man who stopped drinking two days ago is tremulous, diaphoretic and hallucinating. Temperature is 38.1°C, heart rate is 138/min and blood pressure is 174/98 mmHg. He has a history of withdrawal seizures and cannot take oral medication. What is the most appropriate disposition?

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Correct answer: D — Monitored medical admission with high-dose benzodiazepine treatment and thiamine before glucose-containing fluids

Delirium tremens is a medical emergency with autonomic instability and seizure risk. Benzodiazepines, thiamine, fluids, electrolyte correction and monitored admission are required.

Reference: Canadian alcohol withdrawal management guidance; emergency psychiatry practice