Delirium Tidbits - An acute onset syndrome, not a disease.
Hallmark symptom: disturbance of CONSCIOUSNESS accompanied by changes in COGNITION.
Delirium likely caused by direct physiologic process, substance use/abuse, or general medical condition)
Common findings:
-Develops over hours to days
...
Common, and often overlooked. Mistaken for dementia in older persons, and for worsening psychotic
symptoms in those with SMI. Symptoms can persist for months if not recognized; most resolve in 3-6
months if treated.
Delirium incidence, demographic, prognosis - ✔✔0.4% general population
1-2% those >65
14-56% of hospitalized pts
,poor prognosis: 50% mortality rate by 1 year
Early recognition, intervention, treatment is goal: when pts clinical presentation changes rapidly from
baseline, always keep delirium in differential.
Confusion Assessment Instrument (CAM) - ✔✔The Confusion Assessment Method (CAM) includes two
parts.
Part one is an assessment instrument that screens for overall cognitive impairment.
Part two includes only those four features that were
found to have the greatest ability to distinguish delirium or reversible confusion from other types of
cognitive
impairment.
http://consultgerirn.org
Delirium- Non Specific Neuro Abnormalities - ✔✔Urinary Incontinence
Mycoclonus
Nystagnus
Asterixis - flapping motion of the wrists
Increased muscle tone and reflex
Tremors
Incoordination
Delirium- Perceptual Disturbance - ✔✔Illusions most common
Hallucinations - usually visual & accompanied by illusions
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