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Delirium

Diagnosis​

Acute confusion with altered conscious level (fluctuating severity, inattention, disorganised thinking)

Differential​

  • Electrolytes
  • Infection
  • Medication
  • Head Injury
  • Urinary Retention
  • Constipation
  • Pain

Investigations​

  • FBC, CRP, U+E, Bone Profile, LFT, Glucose
  • B12, Folate, TSH
  • ECG
  • Septic Screen - CXR, MSU, ?Blood Cultures
  • ?CT Head
  • ?LP

Management​

Orient: sleep, consistent staffing, vision, hearing, family

Medication as last resort in patients where their symptoms threaten their safety or the safety of others, or to carry out essential investigations or treatment

  • Olanzapine 2.5 mg
  • Lorazepam 0.5 - 1 mg; maximum 2 mg / 24h
  • Haloperidol 0.5 - 1 mg (c.i. Parkinson's)