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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.
Variations in healthcare provider training & experience [45] [52] and failure to acknowledge the prevalence and seriousness of medical errors also increase the risk. [53] [54] The so-called July effect occurs when new residents arrive at teaching hospitals, causing an increase in medication errors according to a study of data from 1979 to 2006.
In Psychology, confusion is the quality or emotional state of being bewildered or unclear. The term "acute mental confusion" [ 1 ] is often used interchangeably with delirium [ 2 ] in the International Statistical Classification of Diseases and Related Health Problems and the Medical Subject Headings publications to describe the pathology .
AEIOU-TIPS is a mnemonic acronym used by some medical professionals to recall the possible causes for altered mental status.Medical literature discusses its utility in determining differential diagnoses in various special populations presenting with altered mental status including infants, [1] children, [2] adolescents, [3] and the elderly. [4]
The SCN is located in the hypothalamus and is associated with regulating sleep patterns by maintaining circadian rhythms, which are strongly associated with external light and dark cues. A disruption within the suprachiasmatic nucleus would seem to be an area that could cause the types of confusion that are seen in sundowning.
Its causes are under investigation and occurs commonly in older patients and those with pre-existing cognitive impairment. [2] The causes of POCD are not understood. It does not appear to be caused by lack of oxygen or impaired blood flow to the brain [3] and is equally likely under regional and general anesthesia.
Ischemic stroke and brain bleeding are other causes of altered consciousness. [12] Infections of the central nervous system may also be associated with decreased LOC; for example, an altered LOC is the most common symptom of encephalitis . [ 14 ]
People in a coma often require extensive medical care to maintain their health and prevent complications such as pneumonia or blood clots. [2] Coma patients exhibit a complete absence of wakefulness and are unable to consciously feel, speak or move. [3] [4] Comas can be the result of natural causes, or can be medically induced. [5]