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Family Medicine

Answer 4
  1. Observation. Delirium is a confusional state characterized by a transient reduction in the clarity of awareness of the environment, accompanied by a fluctuating level of consciousness. This disturbance develops over hours to days, not weeks to months. Risk factors include age older than 80 years, known dementia, fracture or institutionalization prior to admission, and infection. Nonpharmacologic approaches are key to the management of delirium. Presence of familiar faces (ie, family) or moving the person to a well-lit area, such as the nursing station, are initial strategies. Use of restraints or antipsychotic medication should be reserved for patients with severe agitation that causes interruption of essential medical therapies or poses a safety hazard to patient or staff.4

    4. Practice guideline for the treatment of patients with delirium. American Psychiatric Association. Am J Psychiatry 1999;156(5 Suppl):1-20.

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