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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 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).
Substance-induced delirium is a type of delirium caused mostly by Anticholinergic drugs and medications. This type of delirium is separate from the delirium in elderly and older people above 65 years of age, and is characterized by shorter duration (usually several hours), and the symptoms are highly influenced by the type of drug and amount consumed.
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.
A determination of possible deliberate overdose should be considered with appropriate scrutiny, and precautions taken to prevent any attempt by the patient to commit further bodily harm. [ 11 ] [ 47 ] Hypotension is corrected with fluid replacement , although catecholamines such as norepinephrine or dopamine may be required to increase blood ...
Droplet precautions are intended to prevent transmission of pathogens spread through close respiratory or mucous membrane contact with respiratory secretions. Preventative measures such as personal protective equipment can be worn to prevent direct contact with mucous membrane and respiratory secretion.
The 4AT is designed to be used as a delirium detection tool in general clinical settings, inpatient hospital settings outside of the Intensive Care Unit (ICU), or in the community. The 4AT is intended to be used by healthcare practitioners without the need for special training, and it takes around two minutes to complete. [ 4 ]
.3 With delirium (DSM-IV only).20 With delusions (DSM-IV only).21 With depressed mood (DSM-IV only) 290.xx Vascular dementia.40 Uncomplicated.41 With delirium.42 With delusions.43 With depressed mood; 294.1x Dementia due to HIV disease (coded 294.9 in the DSM-IV) 294.1x Dementia due to head trauma (coded 294.1 in the DSM-IV)