A Review of Clinical Evaluation and Management of Delirium OE01-OE04
Dr. Bhupendra Shah,
Assistant Professor, Department of Internal Medicine, BP Koirala Institute of Health Sciences, Ghopa, Dharan-56700, Nepal.
Delirium is a syndrome characterised by the acute onset, fluctuating course of disturbed consciousness and cognitive impairment. It is an important medical condition with poor outcomes. Delirium is still under-recognised problem in intensive care unit. This is our endeavor to review the diagnosis and management of delirium based on the published literature. Two reviewer independently searched Electronic databases MEDLINE/PubMed, Google Scholar, Cochrane library and Scopemed with Mesh (Medical Subject Headings) terms “delirium”, “diagnosis”, and “management” from earliest possible date to January 31st, 2018. Articles in any language especially those published in recent years were given preference. Delirium is categorised into hypoactive, hyperactive and mixed type. The Confusional assessment method is an effective, easy and user-friendly tool to diagnose delirium. The non-pharmacological management like reorientation, mobilisation, and termination of the reversible cause is the initial step of delirium management. Haloperidol is a drug choice for delirium; however, newer antipsychotics are showing promising results.