Delirium Flashcards
How common Is it
50% of hospital elderly patients
0.4% of general population
10-40% of elderly people over 65
What is it’s definition
An acutely disturbed state of mind with a collection of signs such as confusion, irritability , restlessness and loss of awareness and disorientation
Who is it common in
Elderly
Hospitalised patients
Symptoms
Loss of awareness Confusion HallucinAtions Disorientation Low response Restlessness Irritability Agitation
Onset
Rapid within hours or days
Causes
Infection especially Uti Constipation most common cause of confusion in elderly hyperglycaemia and Cushing syndrome Alcohol intoxicatingly Drugs such as opioids and Benzodiazepenes. Hepatic failure of impairment Stroke or MI Dehydration Malnutrition Hypoxia Moving from different environment in hospital Stress Surgery Intracranial tumour
Risk factors
Surgery or hospitalisation Immobilisation Hip fractures Alcohol excess Poor nutrition Sleep deprivation Brain dysfunction
Sign examination and assessment
Check abc Look at news score and blood glucose Do cardio gi resp neuro assessment Amt done regularly Find or what's normal for them and what's not Abg Urine dip stick Bloods to test glucose cal mag vitamin b12 cardiac enzymes
Management
Need to gain informed consent when in lucid state but if not need to follow best interest of patient principles
Supportment management
Reminders of day time where they are and people around them
Do not move
Keep busy
Adequate sleep and control tool lighting feed and avoid disturbances
Meds
Little benefit but can give haloperidol and loazapine antipsychotics
Benzo if alcohol withdrawal
Differentials
Dementia
Anxiety
Schizophrenia
Two types
Hyperactive and hupoaxtive but can xommonly switch between two
Symptoms of both
Hypo Lethargy Inattention Drowsiness Sleeping excessively Slowness
Hyperactive
Confused
Hallunconstion
Irritable and agitated
Mnemonic for causes
Chimps phoned
