Delirium Flashcards
What is delirium?
acute, fluctuating change in mental status, with inattention, disorganised thinking, and altered levels of consciousness
How serious is delirium?
potentially life-threatening disorder characterised by high morbidity and mortality
What is hyperactive delirium?
a condition where a patient might have heightened arousal, with restlessness, agitation, hallucinations, and inappropriate behaviour
What is hypoactive delirium?
a condition where a patient might display lethargy, reduced motor activity, incoherent speech, and lack of interest
What is mixed delirium?
a combination of hyperactive and hypoactive signs and symptoms
What is part of the DSM-5 for delirium?
- Disturbance in attention
- Change in cognition
- Disturbance develops over short period of time e.g. days and hours
- Evidence that disturbance is caused by the direct physiological consequences of a general medical condition, substance intoxication, or substance withdrawal
How common is delirium?
prevalence of delirium in the community is believed to be 1% to 2%, a figure that increases to 14% for patients aged >85 years
What are RF for delirium?
- Older age
- Dementia or cognitive impairment
- Visual or hearing impairment
- History of delirium
- Polypharmacy
What are possible causes of delirium?
- Surgery
- Infection
- Hypoxia
- Drugs/drug withdrawal
What are Ix for delirium?
Look for cause: UTI, Pneumonia and MI Ix: 1. FBC 2. U+E 3. LFTs 4. Blood glucose 5. ABG 6. Septic screen
What is management if delirium?
- Reorientate
- Encourage visits from friends and family
- Monitor fluid balance
- Mobilise and encourage physical activity
- Practice sleep hygiene
- Review medications
How long does delirium develop?
Usually develops over hours and days and delirium may last 1-2 weeks post infection in elderly so don’t assume dementia
