S2D: The Symptom to Diagnosis Podcast Delirium
Apr 21, 2021
Dive into the intriguing world of delirium! Explore a case of a 70-year-old man with acute confusion and how fluctuating mental status sets it apart from dementia. Delve into iatrogenic causes, like medication and alcohol withdrawal, that can trigger this condition. Learn about the Confusion Assessment Method and key points for diagnosis. Discover effective prevention strategies, the importance of a thorough evaluation, and treatment approaches. Plus, hear about common misconceptions and vital pearls for clinicians in recognizing and addressing delirium.
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Case: Hospital-Onset Waxing–Waning Confusion
- A 70-year-old man admitted with UTI and AKI was initially lucid then showed waxing-waning confusion on hospital day three.
- The team at first dismissed a medical student's concern but later recognized true delirium.
Think Iatrogenic Causes And Alcohol Withdrawal
- In-hospital delirium often stems from iatrogenic causes or withdrawal rather than the reason for admission.
- Consider PRN sedatives, narcotics, or alcohol withdrawal when delirium appears as the patient clinically improves.
Delirium Is Defined By Acute Fluctuation
- Delirium is acute, fluctuating mental-status change distinct from chronic dementia and persistent acute confusional states.
- Only after ruling out other causes can persistent acute confusion be labeled delirium.
