Diagnosing and Managing Delirium in Older Adults

Brain_power2Welcome to GEMCAST! In this inaugural episode, first published 09/2015, Kevin Biese talks us through some practical tips for preventing, identifying, and managing delirium in older adults in the Emergency Department.
Delirium is incredibly common among older adults in the ED, but is easy to miss. It is also an independent predictor of 6 month mortality. How is it diagnosed? Why does it matter that we identify it? How can you prevent it? How do you safely treat symptoms of agitation in an older adult? How can you differentiate it from dementia in the acute care setting? – Take a listen.

Links:
For more on the Confusion Assessment Method (CAM) Diagnostic Algorithm, see this checklist from ConsultGeriRN.
To learn more about geriatric EM and the Academy of Geriatric Emergency Medicine, check out the AGEM website. For a website where you can earn CME for learning about the care of older adults, see geri-EM by Don Melady.

References:
1. Barrio K, Biese K. Delirium, dementia, and other mental health disorders of older adults. In: Tintinalli JE, Stapczynski JS, Ma OJ, et al, eds. Tintinalli’s emergency medicine: A comprehensive study guide. 8th ed. ; 2011. Accessed 07/23/2015.
2. Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014;383(9920):911-922. PMID: 23992774
3. Fong TG, Davis D, Growdon ME, Albuquerque A, Inouye SK. The interface between delirium and dementia in elderly adults. Lancet Neurol. 2015;14(8):823-832. PMID: 26139023
4. Han JH, Eden S, Shintani A, et al. Delirium in older emergency department patients is an independent predictor of hospital length of stay. Acad Emerg Med. 2011;18(5):451-457. PMID: 21521405
5. Han JH, Shintani A, Eden S, et al. Delirium in the emergency department: An independent predictor of death within 6 months. Ann Emerg Med. 2010;56(3):244-252.e1. PMID: 20363527
6. Han JH, Wilson A, Vasilevskis EE, et al. Diagnosing delirium in older emergency department patients: Validity and reliability of the delirium triage screen and the brief confusion assessment method. Ann Emerg Med. 2013;62(5):457-465. PMID: 23916018
7. Marcantonio ER. Delirium. In: Pacal JT, Sullivan GM, eds. Geriatrics review syllabus: A core curriculum in geriatric medicine. 7th ed. New York, NY: American Geriatrics Society; 2010
8. Geriatric ED Guidelines

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3 Responses to Diagnosing and Managing Delirium in Older Adults

  1. Pingback: 5 Ways to Geriatricize Your ED |

  2. Pingback: Organic vs Psychiatric Ilness | EM Cases | Best Case Ever

  3. Pingback: Practical Tips for Providing Palliative Care in the ED |

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