Delirium Flashcards
what is delirium?
acute, transient disturbance from a person’s normal cognitive function
causes of delirium
I WATCH DEATH infection withdrawal acute toxins CNS hypoxia deficiencies endocrine acute vascular shock trauma heavy metals
presentation of delirium
rapid onset clouding of consciousness disturbance of cognition hallucinations psychomotor disturbance (hyperalert or hypoalert) sleep-wake disturbance
clouding of consciousness in delirium
worse at the end of the day
drowsy
disorientated
lucid intervals
hallucinations in delirium
visual
threatening
sleep-wake disturbance in delirium
insomnia
sundowning
nightmares
how long does delirium last?
transient and fluctuating course lasting days to months
risk factors for delirium
age dementia sensory deficits perioperative social isolation new environment stress
diagnosis of delirium
cognitive tests= MMSE, 4-AT, MoCA
urine, bloods, etc.
consider imaging
management of delirium
treat cause
manage environment
DO NOT use sedating drugs
antipsychotics e.g. haloperidol, except alcohol withdrawal use BZDs
frequent review as improve quickly or worsen if dementia
hyperactive delirium features
sudden onset confusion agitation restlessness over-active overnight disruptive delusions hallucinations
hypoactive delirium
sudden onset quiet withdrawn sleepy doesn't eat, drink, care unmotivated lazy uncooperative
