China
Africa
Explore chapters and articles related to this topic
Psychosocial Aspects of Diabetes
Published in Jahangir Moini, Matthew Adams, Anthony LoGalbo, Complications of Diabetes Mellitus, 2022
Jahangir Moini, Matthew Adams, Anthony LoGalbo
The two conditions must not be mistaken for each other – especially in the elderly. There is no definitive laboratory test to establish the cause of cognitive impairment. Therefore, it is essential to conduct a thorough patient history and physical examination, along with knowledge of baseline function of the patient. Clinicians often overlook delirium, especially in the elderly. The condition should be considered for any elderly patient with impaired attention or memory. The next diagnostic steps involve use of the Diagnostic and Statistical Manual of Mental Disorders (DSM) or Confusion Assessment Method (CAM). For a positive diagnosis of delirium, there must be the following two components in existence: Acute cognition change that fluctuates during the day, and inattention – the inability to focus or follow what is spoken. Also, one of the following two components must exist: Disturbance of consciousness or having disorganized thinking such as rambling statements, irrelevant conversation, or illogical idea flow.
Neurointensive care: Postoperative management
Published in Hemanshu Prabhakar, Charu Mahajan, Indu Kapoor, Essentials of Geriatric Neuroanesthesia, 2019
Several validated tools are currently available to evaluate for and diagnose delirium. One of the most widely used instruments is the Confusion Assessment Method (CAM). The CAM-ICU can be used in mechanically ventilated patients who cannot speak (50).
Confusion and Terminal Restlessness
Published in Margaret O’Connor, Sanchia Aranda, Susie Wilkinson, Palliative Care Nursing, 2018
A positive score in one or more of these four domains might be due to delirium, but might also be due to dementia, depression, or a psychotic illness. Further assessment is therefore necessary. The ‘Confusion Assessment Method’ (CAM) is a useful diagnostic tool that can be used in many situations, including palliative care (Inouye 1990).
Exploring cognitive impairment in the early stages of an out-of-hospital cardiac arrest – a consecutive case series study
Published in Neuropsychological Rehabilitation, 2023
Marco Mion, Neil Magee, Jean Davis, Kelly Farrell, Eleni Nikolopoulou, Donna Jessup, John Davies, Grigoris Karamasis, Thomas Keeble
All initially comatose patients suffering from an OHCA of presumed cardiac etiology (as defined by Utstein template, see Perkins et al., 2015) admitted to the Essex Cardiothoracic Centre between November 2017 and April 2019 who made sufficient recovery to be discharged alive from ICU were included in this study. Patients suffering from an OHCA of presumed non-cardiac etiology are not routinely seen in our center. They were identified and informally monitored by a senior intensive care nurse, and routinely screened for delirium with the Confusion Assessment Method-Intensive Care Unit (CAM-ICU). After stepdown to a cardiology ward/high dependence unit a first contact was made with the patient (after resolution of delirium, and in preparation for discharge planning), with the aim of providing basic information around common cognitive deficits and psychological difficulties following a cardiac arrest. Verbal consent was sought for referral to neuropsychology; if obtained, the Clinical Psychologist was alerted. At this stage, it was explained to patients that the assessment offered involved paper and pencil testing around their memory, speed of thinking, and other cognitive skills, as well as a few questions around their mood (not included in this paper). They were told this was likely to take around 30 min and it could benefit their recovery if deficits were identified and referrals to appropriate post-discharge services made; however, they remained free to stop/withdraw at any time. No patient declined the assessment; however, three chose not to complete all the tests.
An Oncology Nurse Residency Program Improves Knowledge of Delirium in Older Patients with Cancer
Published in Oncology Issues, 2021
Cassandra Vonnes, Janelle Brown, Joellen Warnke, Tina Mason
Moffitt developed an inter-professional simulated case study of standardized patients, which required the participation of a primary nurse, provider, respiratory therapist, and a standardized patient who was played by a patient advisor. Before participating, patient volunteers trained in patient- and family-centered care with the goal of compassionate care. This delirium simulation is an enhanced learning scenario and was introduced to oncology nurse residents after a geriatric clinical specialist provided a didactic presentation in which learning objectives ask participants to:23Identify presentations of the subtypes of delirium.Review risk factors for the development of delirium in the older adult with cancer.Apply interventions to reduce the onset of delirium.Describe the initial workup of delirium in a hospitalized patient.Use the Confusion Assessment Method for screening of suspected delirium.
Safety of treatment options available for postoperative pain
Published in Expert Opinion on Drug Safety, 2021
Zhaosheng Jin, Christopher Lee, Kalissa Zhang, Tong J Gan, Sergio D Bergese
Delirium is an acute state of mental confusion and a prominent complication of postoperative pain, particularly in the geriatric population and those with preexisting cognitive impairment. Lynch et al performed an observational study examining how postoperative pain affects the development of postoperative delirium. They found an association between higher pain levels at rest and the development of delirium, suggesting that improving postoperative pain control may decrease the risk of delirium in postsurgical patients [5]. Data has shown that postoperative delirium is associated with a myriad of sequelae of its own, including prolonged hospital stay, greater risk of complications, increased mortality, and higher chance of discharge to a long-term care facility [6,7]. Patients at risk of developing delirium should be screened at least daily with the Confusion Assessment Method (CAM) algorithm [8].