ICU Delerium

Question 1

What is delerium

Answer 1

Change in cognition/perception ( STM, disorientation, hallucinations, NOT due to psychiatric conditions, emotional lability, sleep-wake disturbance)

Alterations in LOC (decreased environmental awareness)

Inattention (perseverates)

Abrupt onset (hrs/days)(fluctuates)

Question 2

Delerium subtypes

Answer 2

Hyperactive: 1% (agitated, increased motor activity)

Hypoactive: 44% (sleepy, inattentive)

Mixed: 55%

Question 3

What percentage of ICU pts develop delerium

Answer 3

20-80%

Question 4

Onset of ICU delerium

Answer 4

Day 2 (+/-2)

Question 5

Duration of ICU delerium

Answer 5

4 (+/-2) days

Question 6

ARDS pts and delerium

Answer 6

50% in ICU, 10% at discharge

Question 7

Richmond Agitation Sedation Scale (RASS)

Answer 7

\+4 Combative
\+3 Very agitated
\+2 Agitated
\+1 Restless
0 Alert/calm
-1 Drowsy
-2 Light sedation (<10s eye contact)
-3 Moderate sedation (no eye contact)
-4 Deep sedation (response to physical stimulus only)
-5 Unarousable

Question 8

Presence of delerium has what affect on risk of death

Answer 8

2-13x increased

Question 9

Delerium is associated with long-term_______

Answer 9

cognitive impairments

Question 10

Delerium ICU and Hospital stay

Answer 10

ICU (8 days vs 5 w/o)

Hospital (21 days vs 11 days w/o)

Question 11

Delerium management

Answer 11

Sedation
Sleep
Mobilization

Question 12

_______ is a valid, reliable, and quick assessment for delerium

Answer 12

CAM-ICU