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delirium and confusional states guidelines

Stefan Lorenzl, Ingo Füsgen, Soheyl Noachtar
BACKGROUND: Delirium is common, has multiple causes and causes distress to numerous patients and their relatives. METHOD: Selective review of the literature in PubMed and PsycINFO, with reference to selected national and international guidelines. RESULTS: The hypoactive subtype of delirium is commoner than the hyperactive type, and often overlooked. Delirium in an elderly individual is associated with an additional burden, a possible loss of potential for rehabilitation, and a marked increase in mortality...
May 2012: Deutsches Ärzteblatt International
Emma Ouldred, Catherine Bryant
Delirium is a common condition among hospital inpatients and people in long-term care settings. It is an acute confusional state associated with poor outcomes. Delirium is poorly recognised and managed despite evidence to suggest it is preventable in up to one third of cases. In July 2010, the National Institute for Health and Clinical Excellence published a comprehensive clinical practice guideline on the diagnosis, prevention and management of delirium. This article discusses the clinical features of delirium in relation to the guideline...
March 16, 2011: Nursing Standard
Jonathan Potter, Jim George
Delirium (acute confusional state) is a common condition in older people, affecting up to 30% of all older patients admitted to hospital. Patients who develop delirium have high mortality, institutionalisation and complication rates, and have longer lengths of stay than non-delirious patients. Delirium is often not recognised by clinicians, and is often poorly managed. Delirium may be prevented in up to a third of older patients. The aim of this guideline update is to aid prevention as well as the recognition of delirium and to provide guidance on how to manage these complex and disadvantaged patients...
May 2006: Clinical Medicine: Journal of the Royal College of Physicians of London
Karin Björkman Björkelund, Sylvia Larsson, Lars Gustafson, Edith Andersson
BACKGROUND/OBJECTIVE: The Organic Brain Syndrome (OBS) Scale was developed to determine elderly patients' disturbances of awareness and orientation as to time, place and own identity, and assessment of various emotional and behavioural symptoms appearing in delirium, dementia and other organic mental diseases. The aim of the study was to examine the OBS Scale, using the eight criteria and guidelines formulated by the Scientific Advisory Committee of the Medical Outcomes Trust (SAC), and to investigate its relevance and suitability for use in various clinical settings...
March 2006: International Journal of Geriatric Psychiatry
R P Granacher
Agitation in elderly patients is often caused by acute cerebral failure, more commonly called acute brain syndrome, delirium, or acute confusional state. Defects in cognition, sleep-waking cycles, and psychomotor behavior result. Careful history taking, physical examination, and laboratory testing may reveal a specific, reversible organic factor related to the acute brain syndrome. This article outlines the clues to recognizing agitation due to a cerebral failure and gives guidelines for workup and management...
December 1982: Postgraduate Medicine
D E Raskin
The administration of neuroleptics in the treatment of psychosis and nonspecific behavioral disorders associated with psychotic symptoms in elderly patients is not without consequences. The potential side effects (e.g., dystonia, parkinsonian syndrome, and akathisia) of medications used in treating delirium, dementia, or confusional states are discussed. General guidelines are presented regarding choice of sedatives and antipsychotics and dosage, with attention to management of the individual elderly patient with psychosis...
May 1985: Journal of Clinical Psychiatry
G Hege-Scheuing
In this review we discuss the symptoms, etiology and therapy of reversible organic mental disorders following surgery. Acute confusional states and delirium still pose difficult and unsolved problems in our operative wards and intensive care units. They are a major cause of morbidity and mortality following geriatric surgery. It is necessary to keep a watchful eye for signs of mild cerebral impairment. Slight disorientation, minor fear, depression or delusions can be the first step towards an aggressive or delirious restlessness...
September 1989: Der Anaesthesist
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