Snapshot A 46-year-old male underwent an emergency operation for a lung laceration from an altercation. Twenty-four hours later, he developed anxiety, tremors, and insomnia. The patient is started on a benzodiazepine taper, thiamine, multivitamin, IV fluids, and dextrose. Introduction Occurs when a chronic alcohol drinker is suddenly restricted from drinking login to view 2 more bullets Presentation Symptoms login to view 8 more bullets Treatment Pharmacologic login to view 13 more bullets Complications Minor Withdrawal Alcoholic Hallucinosis Withdrawal Seizure Delirium Tremens Time Since Last Drink 6 hours 12 - 24 hours 48 hours 48 - 96 hours Symptoms Trembling Irritability Anxiety Headache Tachycardia Insomnia Visual, auditory, and in some cases tactile hallucinations Tonic-clonic seizures Autonomic instability Disorientation Hallucinations Agitation Management Thiamine Folate Multivitamin Dextrose IV Flulids Begin benzodiazepine taper to avoid seizures Benzodiazepine taper Head CT Suspect in patient with unknown history followed by DT symptoms 2 days later Benzodiazepine taper prognosis Delirium tremens is associated with a high mortality