Alcohol withdrawal

Presentation and immediate needs

Symptoms following reduction or cessation may include tremor, autonomic arousal, nausea, insomnia, perceptual changes, seizures or delirium.

Begin assessment → History, examination and context

History, examination and context

Establish last intake and prior seizures or delirium, examine vital signs and mental status, and assess concurrent illness, injury, nutrition and sedative exposure.

Consider the branch → Previous severe withdrawal, seizures, delirium or current medical instability?

Previous severe withdrawal, seizures, delirium or current medical instability?

Use clinical findings and collateral. Uncertainty needs clarification, not a default negative answer.

Yes / concerning features → Priority assessment; No / not established → Formulation and care discussion; Uncertain / not assessed → Obtain the missing information

Priority assessment

Arrange an appropriately supervised urgent medical assessment.

After appropriate assessment → Formulation and care discussion

Obtain the missing information

Review the examination, timeline, relevant investigations and consented collateral. Escalate urgent concerns while uncertainty is resolved.

Reassess the branch → Previous severe withdrawal, seizures, delirium or current medical instability?

Formulation and care discussion

Select a supervised setting and locally approved treatment protocol according to clinical severity and vulnerability. Symptom scales support monitoring but do not replace examination or determine a safe setting alone.

Agree follow-up → Reassess and follow up

Reassess and follow up

Reassess frequently according to the care setting. Link acute care to alcohol-use treatment, nutritional support and relapse prevention.