Delirium

• What is delirium?


  Acute, severe confusion -> serious change in mental abilities
• Who does delirium usually effect?


  Elderly
• What is delirium itself a symptom of?


  Underlying health problem or condition
• What are some risk factors for delirium?


  Age (older)

  Significant injury

  Multiple co-morbidities
• What are some signs and symptoms of delirium?


  Altered consciousness

  Lack of concentration/inattention

  Motor changes (hypo/hyperactivity)

  Memory issues

  Decline in personality, thinking, language, mood and behaviour
• How do you differ between delirium and dementia?


  Delirium: Rapid, sudden onset, fluctuating confusion, reversible
• What tests can you do for delirium?


  Confusion screen
• What are some bedside investigations for delirium?


  History

  Examination (neuro)

  Urinalysis

  Cognitive assessment e.g. 4AT or AMT
• What is the 4AT?


  Delirium screening tool
• What is AMT?

  Abbreviated mental test score - assessing patients for dementia
• How do you manage delirium conservatively?


  Depends on cause

  Don't change surroundings

  Hearing aids

  Glasses

  Protect airway

  Give fluid and nutrition

  Catheterise
• How do you manage delirium pharmacologicaly?


  Depends on cause

  Stop medications if they are making confusion worse

  Sedation (in agitated)

  Antibiotics

  Pain relief

  Laxatives
• What may be used to control delirium and agitation in end of life care?


  Haloperidol

  Midazolam