Confusion and Delirium Flashcards
What are risk factors for developing an acute confusional state?
Age > 65 years old,
Background of dementia,
Significant injury (hip fractures),
Frailty or multimorbiditiy,
Polypharmacy
What are some causes of acute confusional state/delirium?
Infection (UTI),
Metabolic (hypercalcaemia, hyperglycemia, dehydration)
Change of environment,
Severe pain,
Alcohol withdrawal,
Constipation
What are features of delirium?
Memory disturbances,
Agitation,
Disorientation,
Mood changes,
Visual hallucinations,
Disturbed sleep,
Poor attention
What is the management of delirium?
Treat underlying cause,
Modify environment,
Haloperidol 0.5mg as first line.
Second line = chlorpromazine
What is the mneumonic for the cause’s of Delirium?
DELIRIUMS
Drugs and alcohol (anti-cholinergics, opioids)
Eyes, ears and emotional disturbance
Low output state (MI< respiratory distress, PE)
Infection,
Retention (urinary or stool)
Ictal
Underhydration or under-nutrition
Metabolic disorders,
What are the investigations for Delirium?
Blood tests: FBC U&E’s, LFTs, TFTs, urinalysis, cultures.
Imaging - depends on senario,
ECG
What factors favour delirium over dementia?
Acute onset,
Impaired consciousness,
Fluctuation of symptoms,
Abnormal perception (hallucinations or illusions),
Agitation or fear,
Delusions