Delirium tremens in a patient under anesthesia.

A 23-year-old male was brought into the emergency room with a traumatic amputation of the distal right leg and extensive burns and crushing injuries of the right hand. Upon admission, he was intoxicated with alcohol. He had no other injuries, and his parents gave no history of any other health problems except his ethanol intake which was greater than one quart per day of hard spirits. His blood alcohol level, taken on admission, was later reported as 370 mgms %. (A lethal dose is between 400 mgms % and 500 + mgms %.) He was taken to surgery for debridement and closure of his wounds; the anesthetic was carried with oxygen, nitrous oxide and halothane and was relatively uneventful. Two days after this first operation, he returned to surgery for further debridement and skin grafts to his right hand. Vital signs were normal except for a fever of 101.80 orally. The patient