Alcohol Withdrawal

WHAT YOU SHOULD KNOW:

Alcohol withdrawal is a physical or mental sickness that happens when you drink alcohol daily and suddenly stop drinking. Withdrawal may also happen if you suddenly reduce the amount of alcohol that you normally drink. The signs and symptoms of alcohol withdrawal normally start between 4 and 24 hours after you stop drinking. The symptoms may be mild at first, and get worse as your body goes through the detoxification process. Detoxification means your body is working to remove the alcohol. Severe symptoms of alcohol withdrawal are often called delirium tremens (DTs). DTs include hallucinations, irritability, and fever. DTs may last up to 5 days and can be life-threatening.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

You may act out violently when you go through alcohol withdrawal. You may harm yourself and others. Severe alcohol withdrawal can cause high fevers, abnormal heartbeats, hallucinations (you see and hear things that are not there), and may be life-threatening.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Psychiatric assessment:

Caregivers will ask if you have a history of psychological trauma, such as physical, sexual, or mental abuse. They will ask if you were given the care that you needed. Caregivers will ask you if you have been a victim of a crime or natural disaster, or if you have a serious injury or disease. They will ask you if you have seen other people being harmed, such as in combat. You will be asked if you drink alcohol or use drugs at present or in the past. Caregivers will ask you if you want to hurt or kill yourself or others. How you answer these questions can help caregivers decide on treatment. To help during treatment, caregivers will ask you about such things as how you feel about it and your hobbies and goals. Caregivers will also ask you about the people in your life who support you.

IV:

An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.

Medicines:

• Sedative: This medicine is given to help you stay calm and relaxed.
  
  
• Anticonvulsant medicine: This medicine is given to control seizures. Take this medicine exactly as directed.
  
  
• Antinausea medicine: This medicine may be given to calm your stomach and prevent vomiting.
  
  
• Glucose: This medicine may be given to increase the amount of sugar in your blood.
  
  
• Vitamin supplement: You may be given vitamin supplements, because alcohol can make it hard for your body to absorb enough vitamins. They may also be given to prevent alcohol-related brain damage.

Monitoring:

• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Heart monitor: This test is also called an EKG or ECG. Sticky pads are placed on your skin to record your heart's electrical activity. An EKG gives information about how your heart is working. Lie as still as possible during the test.
  
  
• Neurologic exam: This is also called neuro signs, neuro checks, or neuro status. A neurologic exam can show caregivers how well your brain works after an injury or illness. Caregivers will check how your pupils (black dots in the center of each eye) react to light. They may check your memory and how easily you wake up. Your hand grasp and balance may also be tested.
  
  
• Intake and Output: For intake and output (I and O), caregivers will keep track of the amount of liquid you are getting. They may also need to know how much you are urinating. Ask your caregiver how much liquid you should have each day. You may need to increase or decrease the amount of liquid you usually have every day. Ask caregivers if they need to measure or collect your urine before you dispose of it.

Tests:

• Blood tests: You may need blood taken to test the amount of alcohol. It can also show if you have decreased levels of vitamins and electrolytes (body salts) in your body. Blood tests can also show if you have damage to organs, such as your liver.
  
  
• Urine sample: A sample of your urine is collected and sent to a lab to test for alcohol.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.
  
  
• CT scan: A special x-ray machine uses a computer to take pictures of your brain. It is used to look for damage that may be causing your symptoms. You may be given dye before the pictures are taken. The dye is usually given in your IV. The dye may help your caregiver see the pictures better. People who are allergic to iodine or shellfish (lobster, crab, or shrimp) may be allergic to some dyes. Tell the caregiver if you are allergic to shellfish, or have other allergies or medical conditions.

Treatments:

• Breathing support:
  
  
  • Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.
    
    
  • Ventilator: This is a machine that gives you oxygen and breathes for you when you cannot breathe well on your own. An endotracheal (ET) tube is put into your airway through your mouth or nose. You may need a trach if an ET tube cannot be placed. A trach is an airway tube put into an incision (cut) in the front of your neck. The ET tube or trach is attached to the ventilator.
  
  

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Alcohol Withdrawal (Inpatient Care)