Transcript Reducing the Risks of Acute Confusion

Reducing the Risks of Delirium- From the Field to the
Hospital
SUSAN SCHUMACHER, MS, APRN -BC
What is Delirium?
Acute, fluctuating
disturbance of
consciousness, attention,
cognition, and perception,
that can affect sleep,
psychomotor activity, and
emotions.
◦(Allen,KR., Fosnight, SM
et.al, 2011)
Incidence and Outcomes Related to
Hospital-Acquired Delirium
2.3 million Americans develop delirium every year
5-61% of orthopedic patients annually; hip fracture patients
highest incidence
18% of patients who develop delirium do not have
resolution 6 months after discharge
50% of patients die within 1 year
Risk Factors for Developing Delirium
Dementia, Parkinson’s Disease, past
delirium
Dehydration (fluid/electrolyte
imbalance)
Pain
Nutritional status
Sensory Deficits (macular
degeneration, hearing loss)
Infections
Medications (polypharmacy and/or
certain drugs)
Hypoxia
Sleep deprivation
What’s the Role of EMS personnel?
If patient has Sensory Deficits:
◦ Bring glasses and/or hearing aids to
Emergency Center
◦ Encourage patient to wear
◦ If family member questions why
these items should be taken to
hospital, please communicate the
importance of patient being able to
see and hear information provided
by hospital staff.
What’s the Role of EMS personnel?
Medications that increase risk of Delirium:
1. Benzodiazepines (ie., Ativan)
2. Antihistamines (ie.,Benadryl)
3. Narcotics (ie., Morphine, Demerol)
4. Hydroxyzine (Vistaril)
There are appropriate uses for any of these medications for older patients, however it’s
important to understand their risks in leading to delirium.
Minnesota Hospital Association- LEAPT (Leading Edge Advanced Practice Topic) for Reducing
Delirium