Delirium Flashcards
What is delirium?
An acute and fluctuating disturbance in level of consciousness, attention and global cognition.
Why is prompt treatment of delirium important?
To avoid potential brain damage
What are some predisposing factors for delirium?
- age > 65 years
- background of dementia
- significant injury e.g. hip fracture
- frailty or multimorbidity
- polypharmacy
What are the risks of being treated for delirium in the hospital?
- Prolonged hospital stays
* Increased risk of institutionalisation
How long does delirium usually last?
Less than 6 months
What are possible symptoms of delirium?
- memory disturbances (loss of short term > long term)
- may be very agitated or withdrawn
- disorientation
- mood change
- visual hallucinations
- disturbed sleep cycle
- poor attention
- reduced levels of consciousness
How do delirium symptoms change as the day progresses?
Symptoms tend to fluctuate over the course of the day
the symptoms are worse at night
What factors contribute to delirium
Dehydration (important) • Constipation • Hypoxia • Infection • Multiple medications • Pain • Poor nutrition • Sensory impairment • Sleep disturbance
What are 2 possible ways that delirium could be diagnosed?
A Mini-mental state exam
Confusion Assessment Method (CAM)
What could a mini-mental state exam show?
Deficits in attention
What features does CAM (confusion assessment method) say are diagnostic of delirium?
- Acute change in cognition which fluctuates during the day;
- Inattention;
- Disturbance of consciousness;
- Disorganised thinking.
What is the initial management of delirium?
Treating the underlying cause or removing aggravating drugs
What is the environmental management of delirium?
Nurse patients in a quiet and well-lit room.
What should be minimised and avoided for patients recovering from delirium?
Minimise sensory deficits (check hearing aids/glasses etc.)
Medications should be avoided as far as possible
What is the first line sedative if needed in delirium?
haloperidol 0.5mg
