delirium is common in elderly hospital inpatients and is associated with increased morbidity and mortality
early recognition, investigation and management with appropriate inpatient team care is essential to good outcomes by minimising functional and cognitive decline, pressure ulcers and preventing falls.
it should be differentiated from a primary psychiatric diagnosis such as a psychosis, or from drug or alcohol related withdrawal states.
is it delirium?
ED Mx of the elderly patient with delirium
exclude and treat potential time critical causes
assess cognitive state
general ED care
pillow under legs to keep heels from contact
avoid routine IDC insertion
bladder scan after each void + minimum once per nursing shift to detect acute urinary retention
and Mx accordingly (eg. consider in/out catheter but if needed more than twice then insert IDC)
early referral to Aged Care inpatient team if aged > 65 years or with known dementia and not likely to be a primary psychiatric diagnosis (otherwise refer to Aged Persons Mental Health Unit)
ED Mx of behavioural disturbance and aggression
n_delirium.txt · Last modified: 2018/03/19 23:38 by wh