Delirium Flashcards
what is delirium
an acute state of mental confusion in direct consequence of an underlying issue
list some causes of delirium
general medical conditions such as infection
intoxicating substance or withdrawal
medication use
immobility or prolonged hospital stay
list the 5 main features of delirium
acute onset fluctuating course disturbance in attention changes in cognition altered conscious level
is delirium reversible
yes
what are the two subtypes of delirium
hyperactive
hypoactive
describe the features of hyperactive delirium
heightened arousal - agitated, restless and aggressive
usually fine during day then presents at night
disruptive behaviour and hallucinations
describe the features of hypoactive delirium
lethargic, slow and withdrawn
reduced motor activity, incoherent speech and lack of interest
patient often eat and drink less
hypoactive delirium is commonly misdiagnosed for what
depression
what is the first screening tool useful for delirium
4AT
what are the components of the 4AT
alterness
AMT4
attention
acute changes/fluctuating
a score of what and above on the 4AT indicates delirium
4 and above
what must be initiated within 2 hours of someone presenting with delirium
TIME bundle
what are the components of the time bundle
T - assess triggers
I - investigate with fluid balance, bloods, CXR, cultures
M - manage - treat underlying causes
E - explain - document diagnosis and explain to family
what are the non-pharmacological methods of managing delirium
sleep chart early mobilisation make sure glasses and hearing aids are in and working re-orientate with clock put in a side room
when is medication indicated for delirium
if the patient is being aggressive or at risk to themselves or others
