Delirium Flashcards
1
Q
what is delirium?
A
acute deterioration in mental functioning arising over hours or days
2
Q
why is delirium a medical emergency?
A
there is increased risk of falls, dementia, dehydration, malnutrition and death
3
Q
risk factors for delirium
A
elderly cognitive impairment post-op sensory impairment co-morbidities previous drugs/ alcohol depression polypharmacy
4
Q
causes of delirium
A
Mnemonic= DELIRIUM Drugs Electrolyte disturbance Lack of drugs (withdrawal) Infection Reduced sensory input Intracranial (stroke/subdural) Urinary retention/ constipation Metabolic (AKI, low glucose, low thyroid, B12/folate, Ca2+)
5
Q
presentation of delirium
A
acute onset fluctuating course throughout the day altered consciousness (hyper/hypo) inattention/ decreased awareness disorganised thinking (psychotic features)
6
Q
diagnosis of delirium
A
4-AT
CAM
7
Q
what does the 4-AT test?
A
alertness
8
Q
what score for the 4-AT indicates delirium?
A
> 4
9
Q
what screening tool is used after the 4-AT?
A
TIME bundle to consider triggers and investigations
10
Q
management of delirium
A
identify and treat underlying cause assess capacity environment measures sensory input haloperidol PO or IM if severe psychosis
11
Q
when to not use haloperidol in delirium?
A
PD/LBD
use lorazepam instead
12
Q
screening tools used to assess capacity
A
AWI
POA
13
Q
environment measures in delirium
A
minimal patient moves activity food chart fluid chart bowel chart
14
Q
prevention methods for delirium
A
medication review
early mobilisation
review bowel and bladder function
