Professional Documents
Culture Documents
Case
93 ♂
PC
4/7 Confusion, agitation + general
deterioration
3/7 poor urine output
PMH
BPH
Long term catheter in situ
MI
DH
Omeprazole 20mg po od
Betahistine 8mg po om
Aspirin 75mg po om
Calcichew D3 forte
SH
Lives with wife
No carers
Independent around house
Enjoys doing crosswords
Recent falls
O/A
Temp 35.8
Dehydrated
GCS 13/15
AMTS 7/10
Urine
offensive odour
Dip +ve blood, leukocytes, nitrites
Bloods
WCC 14.1
Neut 9.7
Hb 12.0
Na 126
K 4.4
Urea 3.8
Creat 78
CRP 10
Diagnosis
Acute confusion
UTI
Hyponatraemia
Ciprofloxacin 5/7
Omeprazole + betahistine stopped
Day 2
GCS 7/15
CT Brain
Small vessel ischaemia
No evidence of space occupying lesion,
intracranial haemorrhage or skull #
CRP 46
After 2/52
GCS 15
AMTS 10/10
A/W discharge home
Prophylactic trimethoprim
Delirium
Derived from Latin ‘off the track’
Delirium
Transient global disorder of
cognition
Medical emergency
Affects 20% patients on general
wards
Affects 30% of elderly medical
patients
Associated with increased mortality,
increased nursing, failed rehab and
delayed discharge
Presentation