ICU Map
toxicology

Severe Withdrawal With Agitation or Seizures

Hyperadrenergic delirium, hallucinations or seizures after alcohol/benzodiazepine reduction.

Recognize

  • Confirm exposure/timing while excluding sepsis, hypoxia, intracranial disease, intoxication and metabolic causes.

Act now

  • Provide adequate GABAergic therapy; benzodiazepines are first-line for alcohol withdrawal, with phenobarbital as an experienced-clinician option. Give thiamine and correct electrolytes.

Reassess

  • Do not let dexmedetomidine, clonidine or antipsychotics mask undertreated withdrawal; they do not replace seizure-preventing GABAergic therapy.

Evidence status

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Actionable Clinical Workflows (6)

Step-by-step ICU Processes
Neuromuscular Respiratory Failure

Bedside trajectory assessment, respiratory mechanics, bulbar function, airway timing, and disease-specific immunotherapy in acute neuromuscular crisis.

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ICU Sedation Titration & ABCDEF Liberation

From 'analgesia-first' multimodal pain control and light sedation targeting to daily SAT/SBT coordination, delirium screening, and early mobility.

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Acute Neurologic Deterioration & Brain Death Workflow

From acute GCS drop and herniation emergency measures to emergent CT, neurocritical intervention, and death by neurologic criteria determination.

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Status Epilepticus Emergency Management

From emergent first-line benzodiazepine administration to second-line IV non-sedating AEDs and continuous cEEG anesthetic burst suppression.

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Deep-Dive Topic Destinations (3)

Reference Knowledge
Alcohol & Benzodiazepine Withdrawal in the ICUtoxicology

Recognition and treatment of severe withdrawal, delirium tremens and withdrawal seizures with symptom-triggered or front-loaded GABAergic therapy.

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ICU Sedation, Analgesia, Delirium & Liberationneurology

Analgesia-first sedation, light sedation targets, ABCDEF bundle, spontaneous breathing trials, and non-pharmacologic delirium mitigation.

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Status Epilepticusneurology

Recognition and time-sensitive escalation of care for prolonged or repeated seizures.

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