Delirium Flashcards
What is it?
It is a disturbance in attention, and change in cognition that will develop over a short period (ie hours to days). Presentation will often fluctuate over this time period.
Predisposing factors
advanced age pre-existing dementia co-morbidity post-op terminal illness sensory impairment polypharmacy depression alcohol dependency malnutrition
Precipitating factors for delirium
P - pain I - infection N - nutrition and neuro C - constipation and catheter H - hypoglycaemia, hypo/hyperthyroid, hypoxia, hydration M - medication E' - environment
what is a precipitating factor
things likely to cause it
what is a pre-disposing factor
things making it more likely
words associated with delirium
“Acute confusion” “Acute confusional state” “Confusion” “Agitation” “Toxic psychosis” “Off the legs” “A bit knocked off”
“Non-compliant with examination” “Disorientated in TPP” “Acute brain failure” “Global brain dysfunction” “Unable to obtain history” “Vague” “UTI” “not themselves today”
the hallmarks for delirium
acute and fluctuating inattention altered level of consciousness disorganised thinking change in perception
someone who is agitated, aggressive and wandering
hyperactive delirium
someone who is withdrawn, apathetic, sleepy and in a coma
hypoactive delirium
is there a difference in prognosis between hyper and hypoactive delirium
yes - hypoactive is twice as likely to die
Ix for delirium
the 4AT and CAM
Tx for delirium
- reverse precipitants
- environmental and supportive factors
- engage and reassure
- symptoms control
give examples of symptom control
haloperidol/quetiapine/benzos
when to avoid haloperidol
parkinsons and lewybody
what to use instead of haloperidol in someone with parkinsons or lewy body
quetiapine
