Managing Delirium In The Emergency Department: Tools For Targeting Underlying Etiology

Abstract

Delirium represents the complex junction between vulnerable patients, medical conditions, and environmental factors. Given the varied presentations of this disorder and the emergency department clinical environment, recognition and treatment may be challenging. Delirium can be diagnosed using validated standardized screening tools such as the Confusion Assessment Method. Management of delirium is directed towards rapidly treating the underlying medical condition while preventing and managing the behavioral symptoms with nonpharmacological (first-line) and pharmacological (second-line) interventions. In the severely agitated patient, pharmacological treatment tailored to the patient's age and comorbidities may be required as the initial treatment to facilitate evaluation and management of the underlying medical condition. Effective risk stratification and triage tools can positively impact patient and staff safety, as well as patient outcomes.