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Delirium (formerly acute confusional state, an ambiguous term that is now discouraged) [1] is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days.
The Confusion Assessment Method (CAM) is a diagnostic tool developed to allow physicians and nurses to identify delirium in the healthcare setting. [1] It was designed to be brief (less than 5 minutes to perform) and based on criteria from the third edition-revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R) .
The Abbreviated Mental Test score (AMTS) is a 10-point test for rapidly assessing elderly patients for the possibility of dementia.It was first used in 1972, [1] [2] and is now sometimes also used to assess for mental confusion (including delirium) and other cognitive impairments.
The most common causes of drug induced acute confusion are dopaminergic drugs (used for the treatment of Parkinson's disease), diuretics, tricyclic, tetracyclic antidepressants and benzodiazepines or alcohol. The elderly, and especially those with pre-existing dementia, are most at risk for drug induced acute confusional states. [8]
Treatment depends on the degree of decrease in consciousness and its underlying cause. Initial treatment often involves the administration of dextrose if the blood sugar is low as well as the administration of oxygen, naloxone and thiamine. [citation needed]
There are many areas where patient education can improve the outcomes of treatment. For example, in patients with amputations, patient education has been shown to be effective when approached from all angles by the healthcare team (nurse, primary care physician, prosthetist, physical therapist, occupational therapist etc.).
If possible, a consistent sleeping schedule and daily routine that a patient is comfortable with can reduce confusion and agitation. [4] If the person's condition permits, having increased daily activity incorporated into their schedule can help promote an earlier bedtime and need for sleep. [4] [5] Check for over-napping. People may wish to ...
The overarching principle of delirium treatment is finding and treating the underlying cause. If the patient is truly experiencing delirium, their symptoms should begin improving/resolving with proper treatment of their illness, intoxication, etc. [ 9 ] Medication such as antipsychotics or benzodiazepines can help reduce the symptoms for some ...