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8 Cards in this Set

  • Front
  • Back
what is the old criteria to diagnose delirium?

1. Acute in onset (hours to days)

2. Fluctuates throughout the day

3. Cognitive disturbance and inattention

4. Altered consciousness (hyper-alert, stupor, drowsy)

What are the causes of delirium?

well... many

what are some of the risk factors for delirium?

- old age

- polypharmacy (steroids)

- anemia

- substance misuse

- electrolyte disturbances

- post-op

what is the general management for delirium?

1. stabilize the patient

2. monitor vital signs, I/O chart

3. regular investigations to identify the cause

4. discontinue unnecessary medicine

5. rehydrate patient

6. identify sources of pain

what are some of the non-pharmacological treatments?

1. no mechanical restraints

2. thrice daily re-orientation via reality orientation board

3. early mobilization

4. visual or hearing aid provision

5. rehydration

6. sleep enhancement via warm milk, music, tapes

7. bright light therapy from 6-10pm

8. minimize lines and tubes

9. encourage family members to come daily

what are the pharmacological treatments for delirium?

- 0.5-5.0 mg of haloperidol daily

- Adequate pain management

*** avoid BZD and anticholinergic agents, these will make patient more confused

prognosis of delirious patients?

- typically lasts 10-12 days, but may be up to 2 months

- mortality rate is high, at 6-18%

- 60% will have persistent cognitive deficits, so treat fast

- 3x higher risk of dementia

describe chemical restraint

Applyingchemical restraint:

1)Try oral medication first: Olanzapinezydis 10mg or Risperidone quicklet 1mg or lorazepam 0.5to 1mg stat.

2)If fails: IM lorazepam 2mg (if antipsychotic naïve) or IMHaloperidol5-10mg stat

3)If still fails, combine IM lorazepam 2mg and IM Haloperidol 10mg 30minutes to 60 minuteslater.