Delirium Flashcards
What is delirium?
The change in cognition from the patient’s baseline in a short period of time that fluctuates
The onset of delirium is gradual/sudden
Sudden
How long can delirium last?
From hours to a month
Which neurotransmitter is thought to be deranged in delirium?
ACh
Give some predisposing factors for delirium
Elderly Dementia Co-morbidity Post-operative Polypharmacy Depression Alcohol Malnutrition
What are the hallmarks of delirium?
Acute fluctuating onset
Not able to follow thoughts
Hyper/hypoactive
Rambling/delusional
What are the two subtypes of delirium?
Hyperactive
Hypoactive
What are signs of a hyperactive delirium?
Agitated
Aggressive
Wandering
What are signs of a hypoactive delirium?
Withdrawn
Apathetic
Sleepy
Give some tools used to assess delirium?
4AT score
CAM
What are signs in the 4AT score?
Alertness
AMT4 (age, DOB, place, current year)
Attention (count months backwards
Acute change/fluctuating course
What is the first step in managing delirium?
Recognising it and the underlying causes/factors
Give some examples of how delirium can be prevented
Early mobilisation Extra nutrition/hydration Medication review Pain management Sleep enhancement
What is the first-line medication used in delirium?
Haloperidol - typical antipsychotic
What medication is used in delirious patients with Parkinson’s/Lewy Body?
Quetiapine
