DELIRIUM(S)

Delirium is one of the most hidden and deadly enemy in ICU. It increases mortality, it cost money and its hard to recognise.

Here is a simple mnemonics for delirium: DELIRIUM(S)

D Drugs, Drugs, Drugs
E Eyes, ears [1]
L Low O2 (MI, ARDS, PE, CHF, COPD) [2]
I Infection
R Retention (of urine or stool), Restraints
I Ictal
U Underhydration/Undernutrition
M Metabolic
(S) Subdural, Sleep deprivation

[1] Poor vision and hearing are considered more risk factors than true causes, but should be "fixed" or improved if possible. Cerumen is common cause of hearing impairment.
[2] "Low O2 states" does NOT necessarily mean hypoxia, rather it is a reminder that patients with a hypoxic insult (e.g. Ml, stroke, PE) may present with mental status changes with or without other typical symptoms/signs of these diagnoses.

An organised effort is underway in the form of website charged by Dr. E.Wesley Ely of Vanderbilt University Medical Center.

http://www.icudelirium.org/