Delirium Flashcards
What is delirium?
acute change in cognition and disturbance in attention
What are the general features of delirium?
develops over a short period
fluctuates over the day
What is the pathophysiology of delirium?
variable derrangement of neurotransmitters (ACh)
normally due to direct toxic insults to the brain i.e. drugs, decreased sodium, decreased glucose or abnormal stress response
What are 3 key predisposing factors of delirium?
polypharmacy
dementia
depression
What is polypharmacy?
> 6drugs
What are the two types of delirium?
hyperactive
hypoactive
Describe hyperactive delirium?
agitated
aggressive
wandering
Describe hypoactiev delirium?
withdrawn
sleepy
coma
OFTEN MISSED - higher mortality
What are the two diagnostic tools to diagnose delirium?
4AT and CAM
What does the 4AT comprise of?
Alertness
AMT4 - age, DOB, place, current year
Attention
Acute change or fluctuating course
What must you score in the 4AT to suspect delirium?
4/12
What does the CAM tool comprise of?
MUST HAVE 1 AND 2 PLUS 3 OR 4 1 acute onset and fluctuating course 2 innattention 3 disorganised thinking 4 altered level of conciousness
What is the management of delirium?
supportive environment
symptom control
identify cause and reverse it
PREVENTION
What pharmacological management can be given for delirium?
Haloperidol (not for Parkinson’s)
Lorazepam - sedative
