Delirium Flashcards
1
Q
What is the definition of delirium?
A
Abnormalities of thought, perception and levels of awareness
2
Q
How common is delirium?
A
Very common
3
Q
What is the pathology of delirium?
A
- Hyper or hypoactive delirium (or mixed)
- Caused by underlying pathology
- Should resolve when pathology resolves
4
Q
What are the risk factors/aetiology of delirium?
A
- Stroke
- Hip fracture
- Vascular surgery
- Terminal illness
- Chronic medical problem
- Malnutrition/dehydration
- Polypharmacy
- Constipation
- Urinary retention
- Infection
- Electrolyte imbalance
- Elderly
- Children
- Dementia
5
Q
What is the mnemonic for the causes of delirium?
A
PINCH ME
Pain Infection/Intoxication Nutritional deficit Constipation Hydration/hypoxia Medication Environment
6
Q
What are the signs/symptoms of delirium?
A
- Acute onset
- Fluctuating symptoms
- Disturbed levels of consciousness
- Cognitive impairment
- Altered sleep wake cycle
- Altered beliefs
- Altered mood
- Hallucinations
- Agitation/restless
- Motor slow/stupor
- Medical illness present
- Withdrawn/quiet
7
Q
What diseases present similarly to delirium?
A
- Dementia
- Depression
- Bipolar
- Functional pyschoses e.g. schizophrenia
8
Q
What investigations are required to diagnose delirium?
A
- AMTS
- DSM-IV
- CAM/CAM-ICU (confusion assessment method)
- Full examination
- Bloods – for underlying cause
- General obs
- EGC
- Urine dip stick
- X-ray/CT
9
Q
What are the pharmacological treatments for delirium?
A
- Treat underlying medical condition
- Analgesia – if required
- Olanzapine/haloperidol – if patient is distressed/risk to themselves/others
10
Q
What are the non pharmacological treatments for delirium?
A
- Keep patient orientated/communicate
- Approach calmly
- Try to avoid unnecessary moving between wards
- Maintain nutrition/fluids
- Mobilise/rehabilitate
- Wash hands
- Avoid constipation/retention
