Delirium

Question 1

What are the four symptoms that constitute delirium?

Answer 1

1. Acute onset and fluctuating course
2. Inattention
3. Disorganised thinking
4. Altered level of consciousness

Question 2

What screening tool is used to look for delirium?

Answer 2

4AT tool

Question 3

What medication is used for most people with delirium?

Answer 3

Halopridol (Oral) . Start with low dose and then increase if needed. Maximum dose of 5mg in 24 hours

Question 4

What medication is given to patients with delirium who also suffer from parkinsons disease?

Answer 4

Quetiepine (25mg orally)

Lorazepam

Question 5

If a benzodiazepine is used in delirium which one should be used?

Answer 5

Lorazepam

Question 6

How long does delirium usually last for?

Answer 6

1 - 4 weeks

Question 7

Give examples of things that make you more vulnerable to delirium?

Answer 7

Age
Dementia
Frailty
Sensory impairment

Question 8

Give examples of things that can precipitate delirium?

Answer 8

Infection
Surgery
Drugs
Dehydration

Question 9

What are the three things that need to be present in d

Answer 9

Acute change and fluctuating course
Altered alertness
Inattention

Question 10

Which has a worse prognosis; hyper or hypoactive delirium?

Answer 10

Hypoactive - also less recognised

Question 11

What is the best tool to diagnose delirium? How does it work?

Answer 11

Confusion assessment method
Must have both
1. Acute onset/Fluctuating course
2. Inattention
AND 1 of
3. Disorganised thinking
4. Altered level of consciousness

Question 12

What drug should you use is delirium?

Answer 12

Haloperidol (oral if possible)

Question 13

What is included in the 4AT tool?

Answer 13

Alertness
AMT4 (age, DOB, place, year)
Attention (months of the year backwards)
Acute change/Fluctuation

Question 14

What drug is used for patients who have delirium who also have parkinsons disease?

Answer 14

Quetiepine