Journal article
Recognition, prevention, and treatment of delirium in emergency department: An evidence-based narrative review
The American journal of emergency medicine, Vol.38(2), pp.349-357
02/2020
DOI: 10.1016/j.ajem.2019.158454
PMID: 31759779
Abstract
Delirium is an acute disorder of attention and cognition that is common, serious, costly, under-recognized, and potentially fatal. Delirium is particularly problematic in the emergency department (ED) care of medically complex older adults, who are being seen in greater numbers.
This evidence-based narrative review focuses on the key components of delirium screening, prevention, and treatment.
The recognition of delirium requires a systematic approach rather than a clinical gestalt alone. Several delirium assessment tools with high sensitivity and specificity, such as delirium triage screen and brief Confusion Assessment Method, can be used in the ED. The prevention of delirium requires environmental modification and unique geriatric care strategies tailored to the ED. The key approaches to treatment include the removal of the precipitating etiology, re-orientation, hydration, and early mobilization. Treatment of delirium requires a multifaceted and comprehensive care plan, as there is limited evidence for significant benefit with pharmacological agents.
Older ED patients are at high risk for current or subsequent development of delirium, and a focused screening, prevention, and intervention for those who are at risk for delirium and its associated complications are the important next steps.
Details
- Title: Subtitle
- Recognition, prevention, and treatment of delirium in emergency department: An evidence-based narrative review
- Creators
- Sangil Lee - Department of Emergency Medicine, University of Iowa Carver College of Medicine, United StatesMichael Gottlieb - Department of Emergency Medicine, Rush Medical College, United StatesPaul Mulhausen - Telligen, Inc, United StatesJason Wilbur - Department of Family Medicine, University of Iowa Carver College of Medicine, United StatesHeather S Reisinger - Department of Internal Medicine, University of Iowa Carver College of Medicine, United StatesJin H Han - Department of Emergency Medicine, Vanderbilt University, United StatesRyan Carnahan - University of Iowa College of Public Health, United States
- Resource Type
- Journal article
- Publication Details
- The American journal of emergency medicine, Vol.38(2), pp.349-357
- DOI
- 10.1016/j.ajem.2019.158454
- PMID
- 31759779
- NLM abbreviation
- Am J Emerg Med
- ISSN
- 0735-6757
- eISSN
- 1532-8171
- Publisher
- Elsevier Inc
- Grant note
- DOI: 10.13039/100000102, name: Health Resources and Services Administration, award: U1QHP28731
- Language
- English
- Date published
- 02/2020
- Academic Unit
- Epidemiology; Emergency Medicine; Family and Community Medicine; Nursing; Center for Social Science Innovation; Injury Prevention Research Center; Internal Medicine
- Record Identifier
- 9984214788102771
Metrics
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