Delirium

Question 1

What is delirium?

Answer 1

Disturbed consciousness (hypo/hyperactive)
Change in cognition
Acute onset and fluctuant

Question 2

What precipitates delirium?

Answer 2

Infection, dehydration, biochemical disturbance, pain, drugs, constipation/urinary retention, hypoxia, alcohol and drug withdrawl, sleep disturbance, brain injury, environmental and emotional distress

Question 3

How common is delirium?

Answer 3

20-30% of all in-patients
50% of people post surgery
Up to 85% of people at end of their life

Question 4

What is the non-pharmacological treatment?

Answer 4

Re-orientate and reassure agitated patient
Encourage early mobility and self-care
Correction of sensory impairment
Normalise sleep-wake cycle
Ensure continuity of care
Avoid urinary catheterisation/venflons
Discharge people ASAP

Question 5

What is the pharmacological treatment?

Answer 5

12.5 quetiapine orally

ONLY IF PATIENT IS A DANGER TO THEMSELVES OR OTHER

Question 6

How can delirium be prevented?

Answer 6

Ensure patients have their glasses and hearing aids
Promote sleep hygeine
Early mobilisation
Pain control
Maintain hydration and nutrition
Regulation of bowels and bladder
Medication review

Question 7

What should be considered if a patient has delirium?

Answer 7

Whether they have capacity or whether a legally appointed proxy should be used

Question 8

What is the link between delirium and falls?

Answer 8

Patients are 4.5x more likely to fall if they have delirium