delirium

Question 1

What causes of delirium exist in the world?

Answer 1

• INFECTION - most common - UTIs, LRTI, menigitis
• trauma - #NOF
• CNS pathology - stroke/lesion
• metabolic causes - liver/kidney failure, DKs, thyroid shit, vitamin deficiencies
• Drugs - lots of
• sleep deprivaiton
• major surgery
• hearing or vision loss
• constipation, urinary retention, pain, dehydration

Question 2

What is the mneumonic for remembering causes of delirium?

Answer 2

I WATCH DEATH
Infection

Withdrawal 
Acute metabolic disorder 
Trauma 
CNS pathology
Hypoxia

Deficiencies 
Endocrine 
Acute vascular things 
Toxins/drugs 
Heavy metals

Question 3

Main symptoms of delirium?

Answer 3

• disorganised tihnking
• illusions
• hallucinations (visual mainly)
• cognitive defects
• emotional liability
• agitation
• reversal of sleep-wake cycle

FLUCTUANT SX + REVERSIBLE

Question 4

Management principles of delirium?

Answer 4

• treat the cause
• antipsychotic medication only used in severe cases when the patient is at risk of hurting themselves or others - haloperidol most frequently used
• reorientation of the patient frequently to time, place and person
• hydrate
• stop precipitating drugs