Delirium

Delirium is an acute disorder of consciousness characterized by attention and awareness difficulties. It has a typically fluctuating clinical course. It can be caused from a wide range of etiologies, and certain patient populations are at increased risk, especially those with dementia or elderly patients. The confusion assessment method (CAM) is a useful screening tool for patients not in an intensive care unit that can help identify patients with delirium. Identification of delirium is pivotal to earlier diagnosis and therapeutic interventions. Delirium is associated with negative clinical outcomes regardless of the severity of illness, age of the patient, or pre-existing history of dementia. The approach toward delirium is aimed at identification of infectious precipitants if present, discontinuation of medications that cause or worsen delirium, prevention of falls, and possible treatment with antipsychotic medications such as haloperidol or risperdal. Other treatments include establishing normal day-night circadian light pattern, and trying to mobilize the patient.