Delirium

Question 1

Causes of Delirium

Answer 1

Drugs/Dehydration
Electrolyte imbalance
Level of Pain
Infection/inflammation (post surgery)
Respiratory failure
Impaction of faeces
Urinary retention
Metabolic disorder/ MI

Question 2

Hyperactive delirium

Answer 2

Increased confusion
Hallucinations/delusions
Sleep disturbance
Less co-operative

Question 3

Hypoactive delirium

Answer 3

Poor concentration
Less aware
Reduced mobility/movement
Reduced appetite

Question 4

Diagnose Delirium

Answer 4

CAM: 1+ 2 + 3/4

1. Acute onset and fluctuating course
2. Inattention (distractible, cannot communicate)
3. Disorganised thinking (illogical, rambling)
4. Altered consciousness (hypo-hyperalert)

Question 5

Onset of delirium

Answer 5

Sudden

Question 6

Before prescribing haloperidol, what should you do first?

Answer 6

Do ECG first (QTc interval)

Question 7

When can you prescribe lorazepam in delirium?

Answer 7

If antipsychotics are contraindicated eg:
Parkinson's disease
Lewy Body dementia
Seizures
Elongated QTc >470ms