How serious/lifethreatening is ETOH detox?

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Specializes in Nurse Leader specializing in Labor & Delivery.

Someone close to us who is an alcoholic (although I don't think we realized until now the extent of it) was planning on going to 30-day inpatient rehab next month. He apparently hasn't had a drink since Sunday, and we found out today that he has been in the hospital since yesterday being treated for DTs. He's on Ativan and Haldol, and is hallucinating. We just learned that he had a seizure and is being transferred into the ICU.

He's relatively young (35ish) with no obvious comorbidities, although his doctor said that he was severely dehydrated and malnourished.

How worried should we be?

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Specializes in EMS, ED, Trauma, CEN, CPEN, TCRN.

If he's in the ICU, they'll take good care of him -- DTs can be a life threat, so he's in the right place. Best of luck to your friend! He has a tough road ahead.

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Specializes in CVICU.

ETOH detox is serious and can be deadly if you try it on your own.

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One of the first things I learned in Psych/Mental Health Nursing is that ETOH detox can be life threatening. Fortunately, there are protocols in place at the hospital to help with detox -

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low Mg, K+=dysrrythmias=bad

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Specializes in Med Surg, ER, OR.

Good luck to your friend as he goes through this. As lunah stated, he is best in ICU until he can come down from this euphoric high he is going through. Ativan and Haldol are the best bets, and he may even need to be placed on an Ativan drip for temporary control, or even intubation.

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Specializes in M/S, MICU, CVICU, SICU, ER, Trauma, NICU.

Extremely, extremely dangerous if not treated.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Yes, I just learned he's on an Ativan drip, and soft restraints. BP and HR are extremely high.

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Specializes in Orthopaedics.

I never want to increase the anxiety of family, but in all honesty, we've been getting a TON of ETOH and alcoholic pancreatitis lately. I've personally lost two in the past 6 weeks, and I wish that weren't so. The perception is that "harder drug" withdrawal is more severe, but ETOH takes people away. That said, I've seen some real positive results as well. The body's a crazy machine. I sincerely hope for the best for you and your family.

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Specializes in multispecialty ICU, SICU including CV.

This is serious. I didn't really understand the physical effects of long term EtOH use until I had to take care of patients in DTs. What happens when you drink regularly, steadily, often, etc. is that your body gets used to the depressant effects of the alcohol and to compensate for that, your body revs it's system up -- all those circulating hormones and neurotransmitters crank up so that the alcoholic begins to be able to function normally with EtOH in his/her system (tolerance.) Then, if one stops drinking abruptly, the depressant effect is instantly gone -- but the body is still all cranked up because it is used to acting that way because of the continuous EtOH bath it has been given. This can be disastrous. Tachycardia, extreme hypertension, hallucinations, seizures, tremors, etc. are all part of the picture and yes, untreated, can kill you. The treatment focus is mostly benzos and other sedatives to replace the EtOH effect, until the body can un-rev itself (which can take up to a week.)

That said, DTs don't happen to everyone -- some have a less serious withdrawal. I think it depends on individual body physiology and the length of time and amount of EtOH use. If your friend is in an ICU, he is in the right place and they can give him as much medication and monitoring as he needs until this gets better. I hope things go well for him and he gets the help he needs to rehab successfully. And, as an FYI, he will probably not remember these events and will need to be appraised of the seriousness of his condition when he comes around.

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Specializes in Foot care.
Good luck to your friend as he goes through this. As lunah stated, he is best in ICU until he can come down from this euphoric high he is going through. Ativan and Haldol are the best bets, and he may even need to be placed on an Ativan drip for temporary control, or even intubation.

Why did you call this a "euphoric high"? It's not euphoric at all. Euphoric means a feeling of well-being or elation. Not what anyone going through ETOH withdrawal is feeling at all.

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Specializes in Nurse Leader specializing in Labor & Delivery.

Thanks everyone for your feedback. Gotta agree with the previous poster - what we saw was anything but euphoric. Last night, according to my husband, he was thrashing and trying to fling himself off the bed.

He's on Ativan 25mg/hour, some type of primary fluid with a K-rider, and a Thiamine piggyback. He's also getting Haldol PRN. He's got parkinsonian tremors, his BP when we saw him today ranged anywhere from 140/100 to 190/140. His heartrate, while in the 110s, was at least a sinus rhythm. They put him on CPAP this afternoon because he was having apneic episodes (2ry to the high doses of Ativan?). I was watching his rhythm on the monitor and between the T and the P, instead of a nice flat line, it was all jig-jaggety. What would cause that?

It's so weird, he was just at our house for BBQ on Sunday, and he seemed perfectly fine and healthy. To see him restrained and tremory and completely out of it a mere four days later was very disconcerting.

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