A man was admitted to the ER at 1405 after having a grand mal seizure at lunch with his wife. He had a history of chronic alcohol abuse, drinking 12-15 beers and one quart of liquor daily for 12 years. His last drink was reported to have been the night before. Seizure protocol was implemented but the time was not documented. While the patient was in the ER the nurses noted at 1430 a rapid heart rate and tremors in the upper extremities. At 1520 the tremors involved the entire body. At 1800 the patient had a grand mal seizure for approximately one minute. His right arm struck the side rail, causing a fracture of the right humeral head. A medQuest registered nurse with expertise in ER care reported the patient was experiencing Delirium Tremens and at risk for frequent seizures since he was withdrawing from alcohol. The hospital's seizure protocol should have been implemented upon the patient's arrival. Notably, there was a negligent failure to provide padded side rails, which would have prevented the injury to the right humeral head.