Assessment and Management of Delirium in Older Adults in the Emergency Department: Literature Review to Inform Development of a Novel Clinical Protocol

Overview

Journal Adv Emerg Nurs J

Specialties Emergency Medicine
Nursing

Date 2015 Jul 29

PMID 26218485

Citations 11

Authors

Tony Rosen

Scott Connors

Sunday Clark

Alexis Halpern

Michael E Stern

Jennifer Dewald

Mark S Lachs

Neal Flomenbaum

Affiliations

Soon will be listed here.

Abstract

Delirium occurs frequently in older patients in the emergency department (ED), is underrecognized, and has potentially serious consequences. Despite its seriousness, delirium is frequently missed by emergency providers, and patients with unrecognized delirium are often discharged from the ED. Even when it is appropriately recognized, managing delirium in older adults poses a significant challenge for ED providers. Geriatric delirium is typically caused by the interaction of multiple factors, including several that are commonly missed: pain, urinary retention, constipation, dehydration, and polypharmacy. Appropriate management includes nonpharmacological management with medication intervention reserved for emergencies. We have developed a new, comprehensive, evidence-based protocol for diagnosis/recognition, management, and disposition of geriatric delirium patients in the ED with a focus on identifying and treating commonly missed contributing causes.

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