Alcohol withdrawal delirium

She smells of alcohol, so not too likely to be in withdrawal at this time.

BUT you need to check that she has not gone a few days with no drink, then remembered her brother was coming and had ‘just one’ to calm her nerves. These are dangerous cases because we smell alcohol and think there is not concern about withdrawal seizures or DTs when these patients are at the highest risk for DTs especially if their Blood Alcohol Level is high at presentation.

You usually can rely on history of being dry and then relapse just prior to visit.

She denies any recent attempts to stop drinking- "Why would I? It helps me cope."