MDCalc

Modified Minnesota Detoxification Scale (mMINDS)

Scores symptoms for patients with alcohol withdrawal.

Pulse, beats/min

Diastolic blood pressure, mmHg

Tremor*

Assess with patient’s arms extended and fingers spread.

Sweat

Hallucinations*

Feeling crawling sensations over skin (tactile), hearing voices when no one has spoken (auditory), or seeing patterns, lights, beings, or objects that are not there (visual).

Agitation, RASS*

Assess using the Richmond Agitation-Sedation Scale (RASS).

Orientation*

Delusions*

Unfounded ideas that can be related to suspicions or paranoid thoughts, i.e., patients believe their things have been stolen or they are being persecuted unjustly.

Seizures

*If unable to assess a parameter secondary to over sedation or mechanical ventilation, score = 0.

Result:

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Advice

Alcohol‑withdrawal treatment protocols vary by institution and may designate preferred benzodiazepines, adjunctive agents (e.g., phenobarbital, dexmedetomidine), and distinct scoring thresholds. Follow your institution’s guidelines for dosing and monitoring.

  • If scores remain high despite appropriate therapy, reassess for alternative causes of agitation.
  • Provide appropriate supportive care, including intravenous fluids, nutritional supplementation, and close vital sign monitoring.
  • After stabilization, involve addiction medicine or social work for long‑term management planning.
Critical Actions
  • Exclude other causes of agitation (e.g., trauma, metabolic derangements, infection).
  • Administer thiamine (before glucose) and correct electrolyte abnormalities while treating alcohol‑withdrawal syndrome.
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