Delirium

Question 1

predisposing factors for delirium ?

Answer 1

age > 65yrs
polypharmacy
significant injury e.g. hip fracture 
co-morbidities / frailty 
background of dementia

Question 2

precipitating factors for delirium ?

Answer 2

infections esp UTI
metabolic e.g. hypercalcaemia, hypo/hyperglycaemia, dehydration
constipation
Change in Environment
alcohol withdrawal
severe pain
significant CV, respiratory, neurological or endocrine condition

Question 3

what is the 1st line sedative used in delirium ?

Answer 3

0.5mg haloperidol

NICE recommend either haloperidol or olanzapine

Question 4

what features would suggest delirium compared to dementia ?

Answer 4

fluctuation of symptoms: often worse at night, periods of normality

impairment in consciousness

abnormal perceptions: hallucinations, illusions

delusions

agitation, fear