5-Minute Emergency Consult
Delirium
Delirium is a topic covered in the 5-Minute Emergency Consult.
To view the entire topic, please log in or purchase a subscription.
Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
-- The first section of this topic is shown below --
Basics
Description
Description
- Delirium is a clinical syndrome characterized by acute changes in awareness, cognition, and perception with a waxing and waning course
- Delirium is often secondary to an underlying acute medical condition
- Pathophysiology unknown:
- Diffuse cerebral dysfunction
- Derangements of cerebral acetylcholine
- CNS dopamine, γ-aminobutyric acid, and serotonin may be involved
- Frequently missed by emergency medicine physicians
- Associated with increased mortality, increased admission, and increased length of stay
Etiology
Etiology
- Neurologic:
- Meningitis or encephalitis
- Seizure
- Wernicke encephalopathy
- Hypoxia and hypoperfusion of the brain
- Intracranial bleed or mass
- Stroke syndrome
- Pulmonary:
- Pneumonia
- Other pulmonary etiology of hypoxia or hypercapnia
- Cardiovascular:
- Hypertensive crisis
- Acute coronary syndromes
- Arrhythmia
- GI:
- Hepatic encephalopathy
- Dehydration
- Renal:
- UTI
- Acute renal failure
- Endocrine:
- Hypoglycemia
- Hyperglycemia
- Hypothyroid
- Rheumatologic:
- Collagen vascular disorder
- Toxicologic:
- Medications or supplements
- Withdrawal from barbiturates or alcohol
- Environmental toxins
- Other:
- Electrolyte abnormalities
- Vitamin deficiencies
- Hypothermia
- Hyperthermia
- Trauma
- Surgery
Geriatric Considerations
- Common presentation in older ED patients
- Up to 10% of older ED patients may have delirium
- Many patients will present with subtle symptoms and vague chief complaints:
- Fall, dizzy, or not feeling well
- Waxing and waning symptoms
- Patients with known dementia are prone to develop delirium from acute medical conditions
- Life-threatening condition
-- To view the remaining sections of this topic, please log in or purchase a subscription --
Basics
Description
Description
- Delirium is a clinical syndrome characterized by acute changes in awareness, cognition, and perception with a waxing and waning course
- Delirium is often secondary to an underlying acute medical condition
- Pathophysiology unknown:
- Diffuse cerebral dysfunction
- Derangements of cerebral acetylcholine
- CNS dopamine, γ-aminobutyric acid, and serotonin may be involved
- Frequently missed by emergency medicine physicians
- Associated with increased mortality, increased admission, and increased length of stay
Etiology
Etiology
- Neurologic:
- Meningitis or encephalitis
- Seizure
- Wernicke encephalopathy
- Hypoxia and hypoperfusion of the brain
- Intracranial bleed or mass
- Stroke syndrome
- Pulmonary:
- Pneumonia
- Other pulmonary etiology of hypoxia or hypercapnia
- Cardiovascular:
- Hypertensive crisis
- Acute coronary syndromes
- Arrhythmia
- GI:
- Hepatic encephalopathy
- Dehydration
- Renal:
- UTI
- Acute renal failure
- Endocrine:
- Hypoglycemia
- Hyperglycemia
- Hypothyroid
- Rheumatologic:
- Collagen vascular disorder
- Toxicologic:
- Medications or supplements
- Withdrawal from barbiturates or alcohol
- Environmental toxins
- Other:
- Electrolyte abnormalities
- Vitamin deficiencies
- Hypothermia
- Hyperthermia
- Trauma
- Surgery
Geriatric Considerations
- Common presentation in older ED patients
- Up to 10% of older ED patients may have delirium
- Many patients will present with subtle symptoms and vague chief complaints:
- Fall, dizzy, or not feeling well
- Waxing and waning symptoms
- Patients with known dementia are prone to develop delirium from acute medical conditions
- Life-threatening condition
There's more to see -- the rest of this topic is available only to subscribers.
Citation
Schaider, Jeffrey J., et al., editors. "Delirium." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307250/all/Delirium.
Delirium. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307250/all/Delirium. Accessed March 29, 2023.
Delirium. (2016). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (5th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307250/all/Delirium
Delirium [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2023 March 29]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307250/all/Delirium.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Delirium
ID - 307250
ED - Barkin,Adam Z,
ED - Shayne,Philip,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307250/all/Delirium
PB - Lippincott Williams & Wilkins
ET - 5
DB - Emergency Central
DP - Unbound Medicine
ER -
