Let’s be clear about delirium

We think we know what a “delirious” patient looks like in the hospital–yelling, throwing things at people, completely alert and dis-oriented x3.

There is the perception that delirium is either completely obtunded or completely manic. In reality, delirium can look like anything between! A delirious person may be able to have a perfectly logical conversation with you until they look outside at the snow on the ground and say, “What a beautiful summer we’re having!”

The critical question to ask is: is cognition impaired? If cognition is impaired, then make a differential based on that. If cognition is NOT impaired, then it may in fact be a psychiatric process at play. For instance, a schizophrenic might have a 30/30 MMSE but will “act crazy”…that’s not delirium. That’s schizophrenia.

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s