Delirium is the term used to describe an acute confusional state that is characterised by disturbances in consciousness, altered cognition and has a fluctuating course. It generally develops over 1-2 days and can be present at the time of a person’s hospital admission. It can also develop at anytime during a hospital admission
All hospital in patients are at risk of developing delirium. However the greatest risk is in elderly patients, patients with pre existing cognitive impairment, patients with hip fractures and patients with a severe illness including ITU patients.
Dementia is not delirium. However at the time of admission it may be difficult to distinguish this. In such a situation the person should be managed as having delirium.
Delirium is associated with poor outcomes. People who develop delirium tend to have:
It is important to identify and treat delirium early. At the time of admission all patients should be assessed for the presence of delirium. This should take into account those people who are at an increased risk i.e. people over the age of 65 years, patients with a pre existing dementia, hip fracture patients and patients with a severe illness.
The management of delirium depends on the cause. Staff can follow this pathway and checklist to appropriately manage patients.