Delirium: Difference between revisions
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== Workup == | == Workup == | ||
#CBC | Main goal is to find the underlying cause. | ||
# | |||
#LFTs | #CBC (eg elevated WBC) | ||
# | #U/E/Cr (eg electrolyte derangements) | ||
#CXR | #LFTs (eg hepatobiliary infection) | ||
#?Utox | #Urine analysis (eg UTI) | ||
#CXR (eg pneumonia) | |||
#?Utox | |||
#?CT/LP | #?CT/LP | ||
Revision as of 11:24, 27 January 2015
Background
Delirium vs. dementia vs. psych
Clinical Features
- Main cognitive impairment is that of inattention (vs memory in dementia)
- Generally develops over hours to days
- Symptoms are classically described as fluctuating throughout the day (ie may appear normal in between episodes)
ED Confusion Assessment Method
- Acute onset of mental status changes and/or fluctuating course
- Anattention
- Disorganized thinking
- Altered level of consciousness
A patient must possess both features 1 and 2 AND either 3 or 4 to meet delirium criteria
Workup
Main goal is to find the underlying cause.
- CBC (eg elevated WBC)
- U/E/Cr (eg electrolyte derangements)
- LFTs (eg hepatobiliary infection)
- Urine analysis (eg UTI)
- CXR (eg pneumonia)
- ?Utox
- ?CT/LP
DDX
- A
- Alcohol
- E
- Electrolyte Abnormalities
- Encephalopathy (hepatic, hypertensive)
- I
- Insulin (hypoglycemia)
- O
- Opiates
- U
- Uremia
- T
- Trauma
- Toxic Exposure
- Thyrotoxicosis
- I
- Infection
- P
- Psych
- S
Treatment
- Treat underlying cause