GIM Question 26 Instructor

What is the definition of delirium?
Delirium is an acute change in cognition characterized by altered attention and awareness, fluctuating confusion/lucidity in a 24hr period, and typically precipitated by an underlying medical cause.

Delirium can also be associated with perceptual disturbances.

How can you manage it?
Management of delirium includes the following:

  • Treat the underlying cause (i.e. infection, pain, metabolic derangement)
  • Reorientation techniques:
    • Avoid moving the patient to new environments
    • Have familiar family members be with the patient
    • Correct sensory deficits (i.e. glasses, hearing aids if needed)
  • Exposure to sunlight to re-establish circadian rhythm
  • Neuroleptic medication if severe agitation:
    • Haloperidol
    • Risperidone, olanzapine, quetiapine (use of atypical antipsychotics has been linked to increased mortality)

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. 5th ed. Washington, DC: American Psychiatric Association; 2013.

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