Delirium Flashcards
1
Q
What is it
A
- Acutely disturbed state of mind characterised by restlessness, illusions + incoherence
- Occurring in intoxication, fever + other disorders
2
Q
How common is it
A
25% older medical pt (50% occur after admission)
Stroke >30%
Hip fracture 50%
Vascular surgery 30%
Terminal illness >50%
3
Q
What are some risk factors
A
- Age
- Dementia
- Neurological
- chronic problem,
- renal impairment
- sensory impairment
- Poypharmacy/ drugs (-OH, anti-depressants, psychotics, epileptics, parkinsonians)
- Immobile
- Acute illness
- Trauma
- Surgery
- Stress
- Restraint/ length of stay / moving environment
- INFECTION
- Stroke, hypoxia
- Malnutrition
- Dehydration
- Constipation
- Co-morbidity
4
Q
How does it present
A
- Rapid onset - hours/days
- Fluctuating symptoms
- Disturbed level of consciousness - inability to focus, drowsiness, cognitive impairment, altered sleep wake cycle
- Suspicious beliefs
- Altered mood
- Hallucinations
- Agitation or restlessness
- Motor slowing or stupor
- Evidence of medical illness
- Withdrawn + quiet
5
Q
What investigations do you perform
A
- AMTS
- MoCA
- trail-finding test
- 4At
6
Q
How do you treat delirium
A
- Treat underlying cause
- Ask family members, carers healthcare professionals
- nutrients, fluids, mobilise, rehabilitate, avoid constipation or retention
- Keep pt orientated
- Reduce stress + manage agitation, rehabilitate, prevent complications, communicate, approach calmly
- Ensure glasses + hearing aids work
7
Q
What are the complications
A
- Increases risk of fall, pressure sores, infections
- Halves chances of returning home + doubles length of stay
- Increases chance of dying
