ABSTRACT
Delirium is commonly encountered in the setting of paediatric consultation-liaison psychiatry. However; it is commonly misdiagnosed as current operational diagnostic criteria may be difficult to apply in children. We present a practical approach to eliciting the signs and symptoms of delirium in children and a proposed treatment algorithm which elaborates a variety of environmental management strategies and includes explicit thresholds for the use of antipsychotic medications
Subject(s)
Antipsychotic Agents , Child , Delirium/diagnosis , Delirium/drug therapy , Signs and SymptomsABSTRACT
Delirium is a disturbance of consciousness; cognition and perception that occurs frequently in medically ill patients. Although it is associated with increased morbidity and mortality; it is often not recognized and treated by physicians. Literature searches were conducted using MEDLINE with the following keywords/ phrases: delirium; acute confusion and management. Additional articles identified by hand-searching in major journals of medicine and psychiatry; and a review of references cited within these sources supplemented the search. In this article; the available published literature regarding the diagnosis; prevention and treatment of delirium is systematically reviewed. Prevention and treatment strategies do not need to be complex or expensive but require well-coordinated interventions from multiple disciplines; including nursing; psychiatry; neurology and primary care; as well as the cooperation and significant effort of family and friends. Atypical antipsychotic agents offer some advantages over haloperidol and in a limited number of studies appear safe and effective for delirium