Delirium Flashcards
What is delirium?
Acute confusional state of impaired consciousness, disorientation and disturbances in perception, and restlessness
What are signs of delirium?
Disordered thinking Euphoria Language impaired Illusion/delusions/hallucinations Reversal of sleep-awake cycle Inattention Unaware/disorientated Memory problems
What can cause delirium?
Drugs Electrolyte imbalance Level of pain Infection Respiratory failure (hypoxia) Impaction of faeces Urinary retention Metabolic disorder
Stroke
Trauma
What are risk factors of delirium?
> 65
Pre-existing dementia
Infection
Bone fractures
What steps can you take when taking a history with someone with potential delirium?
AOX3 - time, place, person
3 step command
Name 3 objects
Ask about pain
Collateral history
What is AMTS?
Abbreviated mental test score
What questions are asked in AMTS?
- age
- time (nearest hour)
- an address (42 west street)
- year
- where they are
- recognise 2 people
- date of birth
- memorable date (WW2)
- name of prime minister
- count down from 20 to 1
repeat remebered address
What score is bad in AMTS?
7 or less
What other test can you do?
MMSE (mini mental state exam)
What investiagations can you do?
Obs Urine dip CXR BM Confusion screen CT head
What observation should you be wary of?
Hypertension + bradycardia = raised ICP
What is in the confusion screen?
FBC U+Es INR LFTs TFTs B12 Folate Calcium
How do you manage delirium?
Supportive management
Treat cause
