Delerium

Question 1

8 signs of delirium using the the letters of DELIRIUM…

Answer 1

Disordered thinking, emotions strong (euphoria, depressed, aggressive), language impaired, illusions/delusions/hallucinations, reversal of sleep-wake cycle, inattention, unaware, memory deficits

Question 2

Causes include?

Answer 2

Pneumonia, UTI, IV line infection, encephalitis, meningitis, opiates, sedatives, anti convulsants, liver failure, stroke, MI, head injury, hypoxia, thiamine or b12 deficiency, post octal phase

Question 3

Differentials?

Answer 3

Anxiety and schizophrenia (however delirium is far more common)

Question 4

What tests would you do?

Answer 4

FBC, U+E, LFT, BMs, ABG, urine dip stick, CXR, blood cultures, ECG

Question 5

Management?

Answer 5

Identify cause, reassure the patient, give them any sensory aids they normally have, keep staff the same, minimise any causative drugs, reassess 1-2 months later

Question 6

If it persists after disease has finished is it delirium?

Answer 6

It can be, especially in elderly symptoms of delirium may persist for several weeks after

Question 7

What is delirium?

Answer 7

Acute reversible global impairment of cognition/awareness/consciousness and behaviour (confusional state)