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