ICU Delirium Flashcards
what is delirium?
change in cognition and/or perception
alteration in LOC
inattention
abrupt onset(hrs/days)
change in cognition and/or perception from delirium include?
Short-term memory, disorientation
Hallucinations: auditory or tactile
Not due to an underlying psychiatric condition
May have delusion, disorg speech, emotional lability, sleep-wake disturb.
subtypes of ICU delirium include?
hyperactive
hypoactive
mixed
hyperactive ICU delirium pts are
agitated
increased motor activity
makes up 1%
hypoactive ICU delirium pts are
sleepy
inattentive
decreased motor activity
make up 44%
Mixed ICU delirium makes up _____%
55%
_____-____ of ICU pts develop delirium at any point and is frequently unrecognized or _______ by clinicians
20-80%
misdiagnosed
onset is usually ICU day ____
2
Duration is usually ____ days
4
what does 4+ mean on the RASS?
combative
what does 3+ mean on the RASS?
very agitated
what does 2+ mean on the RASS?
agitated
what does +1 mean on the RASS?
restless/anxious
what does 0 mean on the RASS?
alert and calm
what does -1 mean on the RASS?
drowsy (eyes open longer than 10 sec)
what does -2 mean on the RASS?
light sedation (eyes open less than 10 secs)
what does -3 mean on the RASS?
moderate sedation (no eye contact)
what does -4 mean on the RASS?
deep sedation (respond only to physical stimulation)
what does -5 mean on the RASS?
unarousable
Delirium is independently associated with _____-____ times increased risk of death
2-13
True or False
There is a correlation that the longer the duration of delirium the higher risk of long term cognitive impairment
true
delirium increased length of stay in ICU from ____ to ___
5 days to 8 days
delirium increased length of stay in hospital from ____ to ___
11 days to 21 days
how is delirium managed?
sedation
improve sleep
early mobilization of pts
True or False
For best delirium management with sedation, maximimze the excess use of benzodiazepines and narcotics
False
minimize
True or False
Decreased sedation, improved sleep quality and early mobilization decrease delirium incidence
True
