Delirium Flashcards
What is the typical history associated with delirium?
Acute onset of confusion, altered level of consciousness. Fluctuating course with periods of lucidity. History of recent illness, surgery, or new medications.
What are the key physical examination findings in delirium?
Altered level of consciousness. Disorientation, agitation, or lethargy. Possible signs of underlying cause: fever, dehydration, hypoxia.
What investigations are necessary for diagnosing delirium?
Clinical diagnosis based on history and symptoms. Blood tests: electrolytes, glucose, renal and liver function tests. Imaging: CT/MRI if head injury or focal neurological signs.
What are the non-pharmacological management strategies for delirium?
Identify and treat underlying cause. Reorientation techniques: clocks, calendars, familiar objects. Ensure safety: prevent falls, use of bed alarms.
What are the pharmacological management options for delirium?
Antipsychotics (e.g., haloperidol) for severe agitation. Avoid benzodiazepines unless alcohol withdrawal is suspected. Symptomatic treatment for underlying causes.
What are the red flags to look for in delirium patients?
Rapidly worsening confusion. Severe agitation or aggression. Signs of severe underlying illness: sepsis, stroke. Failure to improve with initial treatment.
When should a patient with delirium be referred to a specialist?
Severe or refractory cases. Suspected underlying neurological condition. Need for specialized diagnostic evaluation. Persistent symptoms despite treatment.
What is one key piece of pathophysiology related to delirium?
Disturbance in attention and awareness. Often multifactorial: infections, metabolic imbalances, medications. Disruption in neurotransmitter function, particularly acetylcholine and dopamine.
