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Succinct Approach to Delirium in the Emergency Department
Journal article   Open access   Peer reviewed

Succinct Approach to Delirium in the Emergency Department

Sangil Lee, Clay Angel and Jin H. Han
Current emergency and hospital medicine reports, Vol.9(2), pp.11-18
03/18/2021
DOI: 10.1007/s40138-021-00226-9
PMCID: PMC7971395
PMID: 33758677
url
https://doi.org/10.1007/s40138-021-00226-9View
Published (Version of record) Open Access

Abstract

Purpose of Review This study aims to provide a concise delirium review for practicing emergency medicine providers using the Assess, Diagnose, Evaluate, Prevent, and Treat (ADEPT) framework. Recent Findings Delirium is a form of acute brain dysfunction that results in significant mortality and morbidity for older emergency department (ED) patients. Delirium is frequently missed by healthcare providers, but monitoring for this syndrome using brief delirium assessments may improve recognition. Once delirium is diagnosed, emergency medicine providers’ primary goal is to perform a comprehensive history and physical examination to uncover the underlying etiology for delirium. This includes obtaining history from a collateral historian and obtaining an accurate medication history. If posssible, emergency physicians (EPs) should treat the medical etiology that precipitated the delirium. If agitated, non-pharmacologic interventions such that minimize the use of tethers are preferred. Pharmacologic agents such as antipsychotic medications should be used as a last resort. Summary Delirium is a common geriatric emergency and requires the EP to assess, diagnose, evaluate, prevent, and treat. Delirium is a key geriatric syndrome that geriatric ED providers should routinely screen for. A strong emphasis is on the widespread use of delirium screening, followed by prevention and treatment efforts.
Emergency Medicine Medicine Medicine & Public Health Neurologic Emergencies (J Miller Section Editor Topical Collection on Neurologic Emergencies

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