DELIRIUM A significant ICU problem!

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ICU Delirium and Cognitive Impairment Study Group

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Presentation transcript:

DELIRIUM A significant ICU problem! What is it? An acute change in consciousness that is accompanied by inattention and either a change in cognition or perceptual disturbance. May be hypoactive or hyperactive in nature. Who’s at Highest Risk? Patients with pre-existing dementia; history of hypertension; alcoholism; and increased severity of illness. Causes of Delirium: T – Toxic situations (CHF, shock, dehydration, deliriogenic meds, new organ failure) H – Hypoxemia I – Infection/sepsis; immobilization N – Nonpharmacologic interventions being neglected (hearing aids, glasses, uninterrupted sleep, music, noise control, ambulation) K – K+ or electrolyte problems What can we do to Help? A – Awakening B – Breathing trials (spontaneous breathing trials daily) C – Choice of Sedation (decrease BZP use; use alternate sedation) D – Delirium Detection (screening qshift using ICDSC; review of medications) E – Early Progressive Mobility and Exercise