Delirium

Posted On March 6, 2020

Definition

• Alteration of consciousness
  • unable to focus
  • agitation, overactivity
  • tremulousness and hallucinations
• Prevention
  • Avoid multiple medications, dehydration, immobilization, sensory impairment, sleep disruption
  • treat underlying illness
  • if severe disruptive behavior: low dose short acting agent, see below
• Modify risk factor:
  • Orientation: clock, calendar, window with outside view, visits by friends and family. Avoid over stimulation at night.
  • Improve sleep: reduce night interruptions
  • Early mobilization
  • Medication treatment:
    • Limited studies and no consensus
    • Low dose Haloperidol 0.5 to 1 mg im or po, may take 20 min to be effective, as needed, max 5 mg per day
    • Pain: Morphine 5 mg im