Psychiatry Emergencies

Question 1

How common are acute confusional states?

Answer 1

Very - roughly 30% of hospital in-patients get delirium at some point.

Question 2

How should delirium be investiagted?

Answer 2

As organic in cause until proven otherwise.

Question 3

What are the features of delirium?

Answer 3

Rapid onset confusion
Fluctuation of confusion and consciousness
Recent and immediate memory loss
Disorientation
Perceptual disturbance

Question 4

What can cause delirium?

Answer 4

Many things, use a surgical seive:
V - MI, CCF, endocarditis
I - benzos, opiates, digoxin, steroids, parkinsons drugs
T - pain, head injury, intracranial bleed
A - thyrotoxicosis, addisons, DM
M - DM, renal/liver failure, electrolye disturbance
I - any infection, anywhere
N
D
I
C

Pain, constipation, alcohol, drug withdrawal… so many things.