Delirium: Issues in diagnosis and management

Abstract

Delirium is a disturbance of consciousness, cognition and perception that occurs frequently in medically ill patients. Although it is associated with increased morbidity and mortality, it is often not recognized and treated by physicians. Literature searches were conducted using MEDLINE with the following keywords/ phrases: delirium, acute confusion and management. Additional articles identifi ed by hand-searching in major journals of medicine and psychiatry, and a review of references cited within these sources supplemented the search. In this article, the available published literature regarding the diagnosis, prevention and treatment of delirium is systematically reviewed. Prevention and treatment strategies do not need to be complex or expensive but require well-coordinated interventions from multiple disciplines, including nursing, psychiatry, neurology and primary care, as well as the cooperation and signifi cant effort of family and friends. Atypical antipsychotic agents offer some advantages over haloperidol and in a limited number of studies appear safe and effective for delirium.

High-risk factors for delirium in severely ill patients and the application of emotional nursing combined with pain nursing

“…The proportions of different subtypes of delirium in patients with severe disease vary significantly. Delirium is usually a sign of serious illness[ 7 , 8 ], with the cause being often an underlying condition. Delirium can be very serious, and around 15%-40% of hospitalized patients with delirium die within a month.…”