Clinical skills: Managing Delirium Tremens (DTs) and alcohol withdrawal

Delirium Tremens (the "DTs") is the most severe form of alcohol withdrawal and a genuine medical emergency. In this clinical simulation video produced for Bristol Medical School, we demonstrate how to assess and manage a patient presenting with acute withdrawal symptoms.

The scenario follows a patient exhibiting the classic signs of DTs, including severe agitation, confusion, tremors, and hallucinations. The video highlights the importance of rapid assessment using tools like the CIWA-Ar (Clinical Institute Withdrawal Assessment for Alcohol) scale and the critical need for pharmacological intervention to prevent seizures and cardiovascular collapse.

Key points:

Recognition: Identifying the "red flags" of DTs versus mild withdrawal.

Pathophysiology: Understanding the dangerous imbalance between inhibitory (GABA) and excitatory (Glutamate) neurotransmitters in the withdrawing brain.

Management: The role of benzodiazepines (e.g., Chlordiazepoxide or Diazepam) in calming the central nervous system.

Communication: How to de-escalate and reassure a confused or aggressive patient.

This resource is designed for medical students, junior doctors, and nursing staff to better understand the urgency and complexity of addiction psychiatry.

⚠️ Medical Disclaimer: This video is a simulation for educational purposes only. If you or someone else is experiencing alcohol withdrawal, seek immediate emergency medical attention.