Slow responses, confusion Cognitive function

Auditory or visual hallucinations Perception Can be hyperactive, hypoactive or a mixture

Acute disturbance in cognitive function

Reduced mobility, movement, restlessness, Differentials include psychiatric disorders,
Physical function
aggitation, sleep disturbances Diagnosis dementia, depression.

Lack of co-operation, withdrawal,

Social behaviour
alteration in attitude Common, occurs in 60-80% of ITU patients

Use CAM-ICU
Acute onset or fluctuating course

Inattention
Haloperidol 2.5mg IV doubled every 30 mins until settled and
prescribed regularly every 4-6 hrs and tapered off over a few
days
CAM-ICU Altered level of consciousness
Screening
Olanzepine 5mg po can be used.
Disorganised thinking

Involve family
1 and 2 AND 3 or 4 = CAM +ve
CEACCP
Appropriate lighting
iCDSC

Re-orientate patient
Delirium
Modify environment
Introduce cognitively stimulating activities Age

Clock for wake/sleep cycle Alcoholism

Encourage to drink/rehydrate Pre-existing cognitive impairment

Treatment

Treat any hypoxia/infection Depression

MDT approach
Encourage mobilisation if able Hypertension
Risk factors
Review medications Smoking

Resolve any cause of impairment (eg ear Medication

wax), ensure hearing aid/visual aids working

Sleep deprivation
Reduce noise to minimum

Immobilisation
Avoid procedures during the night

Hip fracture
Avoid restraint if possible

Bedside sitter
/Delirium
http://www.nice.org.uk/guidance/cg103/resources/guidance-delirium-pdf

/Delirium/
http://icmcasesummaries.com/2015/09/01/delirium/

/Delirium/CEACCP
http://ceaccp.oxfordjournals.org/content/9/5/144.full.pdf
/Delirium/