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Flashcards in Delirium Deck (15):
1

Delirium

Clinical syndrome involving abnormalities of thought, perception and levels of awareness. Typically of acute onset, and intermittent

2

Features of delirium (DELIRIUM)

Disordered thinking
Euphoric, fearful, angry or depressed
Language-impaired
Illusions/hallucinations/delusions
Reversal of sleep/wake cycle
Inattention
Unaware (disorientated)
Memory deficits

3

Tools used to diagnose delirium

Confusion Assessment Method
4AT

4

Components of the CAM (4)

Acute change in mental status, fluctuating
AND
Inattention
AND
Disorganised speech
OR
Altered consciousness level

5

Which particular kind of delirium is often under-diagnosed?

Hypo-active

6

How can inattention be tested for?

Digit span test (less than seven in abnormal)

7

Aimless, involuntary picking at bedclothes often seen in delirium

Floccillation

8

Contraindications to haloperidol (2)

Lewy body dementia
Parkinsons

9

Commonly missed causes (3)

Urinary retention
Constipation
Pain

10

Complications of delirium in hospital setting (3)

Prolonged stay and increased complications such as:
Nosocomial infections
Falls

11

What does delirium often represent?

An atypical presentation of an acute medical illness

12

Predisposing factors towards delirium (5)

Old age
Pre-existing dementia
Sensory impairment
Terminal illness
Post-operative

13

Components of the 4AT

Alertness
Age, DOB, place, current year
Attention (recite months backwards)
Acute change or fluctuating

14

Sedatives used in delirium (3)

Haloperidol (oral if possible- low dose)
Qutiepine (for Parkinson's, Lewy Body dementia)
Lorazepam

15

How should sedation be given in delirium? (2)

As a last resort when other measures have failed; should be clearly documented in the notes why sedation was required