Delirium Flashcards
Take home message - delirium is
Treatable and reversible
Must be diagnosed and treated early
What is deliirium
Acute confusional state
Disorder of attention and cognition
Common, serious, life threatening and under recognzied
Criteria to diagnose delirum
Evidence that disturbance is caused by consequences of a general medical condition
Disturbance of consciousness
Change in cognition or perception disturbance
Rapid onset and tendency to fluctuate
DSM 5 - delirium
Disturbance in attnetion
Distrubance develops over short period of time
Change in additional cognitive domain
Complications of delirium
Inc mobiditity and mortality
Functional decline
Inc health care costs
Risk factors of delirium
Inadequate fluid intake Dementia Sensory impairment Falling in past 30 days Medications
Delirium acronym
Drugs Electrolyte Lack of drugs Infection Reduced sensory input Intracranial Urinary retention Myocardial
Drugs -
Anticholinergics Anti-inflammatory Benzodiazepines or alcohol GI Opioid analgesics
Predictors of delirium
Physical restrains
New medications
Infection
Dehydration
Delirium assessment
History
Physical
Mental Status
Laboratory
CAM - confusion assessment method
Acute onset and fluctuating course and inattention
Disorganized thinking or altered level of conciousness
Tests of attention
Serial 7s from 100
Serial 3s from 40 or 20
World backwards
Months of the year backwards
Percentage relationship with those that have demtentia that then develop delirium or vic a versa
40% for both
Management
Evaluate and treat medical conditions
Review medication
Attention to care planning needs
Non pharmacological management
Environmental manipulation
Acoustic stimulation
Visual stimulation
