Delirium : Definition, risks factors,diagnosis.pptx

Definition, risks factors, Epidemiology, how to diagnose, management, prevention

1. Ali Awas UST Hospital Resident EFCMG certified

2. Clinical scenario 84 year old male patient is admitted with reduced mobility following a fall which caused left pubic rami fracture - Past history : Diabetes mellitus type 2,BPH,Parkinson disease, AF, Hearing impairment - Meds : amitriptyline, apixaban, metoprolol, oxycodone, metoprolol ,Carbidopa and levodopa - Referred : for rehabilitation - Day three of admission : Nursing staff page you and she said the patient is acutely agitated ,refused evening meds his Temperature is 37.8,refused other check-ups he has not passed urine repeatedly attempting to get up ,states “I am going home”! - Nurse ask : can we have something to sedate him please? What are you going to do ??

3. Learning Objectives -Definition - Importance of delirium Risk factors and precipitating factors - -How to screen or identify delirium -approach to the underlying cause -Management -Outcomes and prognosis

4. Delirium Synonyms -Encephalopathy -Acute brain failure -Acute confusional state Postoperative psychosis - -Intensive care unit psychosis

5. Why is it important?

6. The development of delirium is Multifactorial

7. ,Baseline cognitive function : The time course of present illness Fluid status

8. Clinical scenario 84 year old male patient is admitted with reduced mobility following a fall which caused left pubic rami fracture - Past history : Diabetes mellitus type 2,BPH,Parkinson disease, AF, Hearing impairment - Meds : amitriptyline, apixaban, metoprolol, oxycodone, metoprolol ,Carbidopa and levodopa - Referred : for rehabilitation - Day three of admission : Nursing staff page you and she said the patient is acutely agitated ,refused evening meds his Temperature is 37.8,refused other check-ups he has not passed urine repeatedly attempting to get up ,states “I am going home”! - Nurse ask : can we have something to sedate him please? What are you going to do ??

9. Thank you for your attention

10. References UpToDate - -Harrison principals of internal medicine 21th edition -American delirium society -New England journal of Medicine