Delirium Tremens || Thiamine in EMS
Delirium tremens is a severe form of alcohol withdrawal that can actually turn into a fatal situation. This condition typically sets in 48-72 hours after the last alcoholic drink was consumed and as the severe withdrawal symptoms begin. These symptoms include hallucinations, tremors, poor motor function, tachycardia, diaphoresis, pain, anxiety and fear.
Chronic alcoholism can cause a deficiency in thiamine and this specific deficiency is known to cause Wernicke encephalopathy. Thiamine is beneficial for those experiencing delirium tremens for the prevention/treatment of Wernicke encephalopathy & Korsakoff syndrome.
Thiamine, however, is not the most important prehospital treatment for DTs as its benefits will not be seen immediately. The administration of a benzodiazepine (follow your protocol & stay within your scope) & treatment for dehydration will benefit the patient in the prehospital setting in a more immediate fashion.
If your EMS service carries thiamine, the onset of delirium tremens would be the ideal time to administer it, but don’t forget the treatments that are going to help immediately. If you are interested in learning more about thiamine, please click the link for the full breakdown on YouTube.