Management of delirium

While the search for cause of delirium is critically important, organ failure and metabolic disorders may not be correctable and one must manage the delirium recognizing that one cannot eliminate the cause. With pain medications, they can often be titrated or switched to another, but the delirious side-effects may have to be managed. Patients and families should be reassured about the fact that they are not 'crazy' and that the delirium is illness or treatment related. A relative or familiar person should be present to interpret the environment and events. Restraints should be used for protection as needed, with all precautions for patient safety.

Medications useful for control of delirium are the antipsychotics with lorazepam added to control agitation and restlessness. (30) T.a.b.le.,1.,3 gives the medications commonly used for control of delirium. Haloperidol remains the most useful because of its multiple routes of administration. However, newer antipsychotics are proving useful, particularly risperidone and olanzepine. Lorazepam is a helpful adjunct for agitation, along with haloperidol (27> (see Chapter,4:.1..12).

Cku rTij i Amur

TlMÉAH

OtfifpflFtllTH fapndor^-

•J-fLvnrtm lU-Hm^-tlh 1 4-L] h 15—1 Hl rary 11 h

PQMC

PO

LcrutpoFi

lïlK*

Y 1 4h

Pftrv.n

» Itt.t,

tt.K

Fi*, rrc-rr. Ktki

C

■ ■i.i.Mll m»

Table 13 Medications used in treatment of delirium

Table 13 Medications used in treatment of delirium

A large study recently explored the risk of factors for delirium, which are applicable in the older patients who are most vulnerable to develop delirium. Preventive interventions to consider are orientation and reorientation to persons and environment, using cognitively stimulating activities, non-pharmacological intervention for sleep improvement (e.g. milk or back rub at bedtime), sleep-enhancement strategies (e.g. noise reduction), ambulation exercises, visual aids, hearing aids, and early recognition of dehydration. (3!>

Your Perfect Right

Your Perfect Right

Always wondered if you could use assertiveness and equality in your relationships and in your life? Here are some great information on how to be more assertive! Do you want to improve your career and the amount of money that you bring home? Do you want to break all the sales records in your office? Do you want to bring home more money? Do you feel as though you are just short of reaching all of your goals?

Get My Free Ebook


Post a comment