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Delirium (formerly acute confusional state, an ambiguous term that is now discouraged) [1] is a specific state of acute confusion attributable to the direct physiological consequence of a medical condition, effects of a psychoactive substance, or multiple causes, which usually develops over the course of hours to days.
The incidence of emergence delirium after halothane, isoflurane, sevoflurane or desflurane ranges from 2–55%. [10] Most emergence delirium in the literature describes agitated emergence. Unless a delirium detection tool is used, it is difficult to distinguish if the agitated emergence from anesthesia was from delirium or pain or fear, etc.
Richmond Agitation-Sedation Scale (RASS) is a medical scale used to measure the agitation or sedation level of a person. It was developed with efforts of different practitioners, represented by physicians, nurses and pharmacists. [1] [2] The RASS can be used in all hospitalized patients to describe their level of alertness or agitation. [3]
The Confusion Assessment Method (CAM) is a diagnostic tool developed to allow physicians and nurses to identify delirium in the healthcare setting. [1] It was designed to be brief (less than 5 minutes to perform) and based on criteria from the third edition-revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-III-R).
More severe symptoms may include seizures, and delirium tremens (DTs); which can be fatal in untreated patients. [1] Symptoms start at around 6 hours after the last drink. [2] Peak incidence of seizures occurs at 24 to 36 hours [5] and peak incidence of delirium tremens is at 48 to 72 hours. [6]
Before the term "excited delirium" was rejected by the ACEP in 2023, its supposed risk factors vary including "bizarre behavior generating phone calls to police", "failure to respond to police presence", and "continued struggle despite restraint". It supposedly endows individuals with "superhuman strength" and being "impervious to pain".
Psychomotor agitation is a symptom in various disorders and health conditions. It is characterized by unintentional and purposeless motions and restlessness, often but not always accompanied by emotional distress and is always an indicative for admission.
Bell's mania, also known as delirious mania, refers to an acute neurobehavioral syndrome. [1] This is usually characterized by an expeditious onset of delirium, mania, psychosis, followed by grandiosity, emotional lability, altered consciousness, hyperthermia, and in extreme cases, death. [1]