Communication: a person-centred approach
Nicola Neale, Joanne Sale in Developing Practical Nursing Skills, 2022
Acute confusion is usually defined as having a rapid onset and is characterised by changeable levels of consciousness often with an impaired ability to think and concentrate. NHS UK suggests that individuals who have sudden confusion (delirium) may have difficulty thinking or speaking clearly. They may feel disorientated and struggle to attend to their surroundings and some people also have hallucinations – seeing or hearing things that are not there (www.nhs.uk/conditions/confusion). Sudden confusion can be caused by a number of conditions for example low blood sugar, some medications, infection, alcohol or head injury. It is therefore crucial that thorough assessment is carried out and ensuring appropriate communication skills are applied sensitively.
General Medical Emergencies
Anthony FT Brown, Michael D Cadogan in Emergency Medicine, 2020
Features of severe CAP requiring hospital admission include one or more of the following: Respiratory rate ≥22/min.Systolic BP <90 mmHg or diastolic BP <60 mmHg.Acute onset of confusion.Arterial or venous pH <7.35.Oxygen saturation <92%, or PaO2 <60 mmHg (below 8 kPa).Multilobar CXR changes.Urea of >7 mmol/L, WCC <4 × 109/L or >30 × 109/L, lactate >2 mmol/L.
Geriatric headache
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby in Headache in Clinical Practice, 2018
Chronic SDHs, grouped by the IHS with ‘headaches associated with vascular disorders’,9 often act as mass lesions and may present with headache symptoms similar to those of brain tumors. The elderly are at greater risk for SDHs, owing, in part, to brain atrophy; this decreases the support of bridging veins, increasing the risk for venous tears with minor head injury. Because SDHs are extra-axial (outside the brain parenchyma), they are less likely to produce early neurologic deficits. Even large lesions may produce headache with no focal neurologic dysfunction. Some patients present with headache and confusion or a fluctuating level of consciousness. SDH may present long after trauma. Unfortunately, trie history of an antecedent head injury is often absent, sometimes because the patient has forgotten the incident.
Recovery after volleyball: a narrative review
Published in The Physician and Sportsmedicine, 2020
Brian Closs, Connor Burkett, Jeffrey D. Trojan, Symone M. Brown, Mary K. Mulcahey
Additionally, the so called ‘home court advantage’ may be partially attributable to improved sleep, as volleyball players tend to have lower sleep quality and increased nocturnal awakenings the night before away games compared to the night before home games or training days [27]. In 2016, Andrade et al. administered sleep and mood questionnaires to volleyball players 30 minutes before their matches began [28]. The questionnaires measured tension and confusion levels in relation to both sleep quality and match outcomes. Confusion was defined as a combination of unusual responses to anxiety and/or depression, feelings of uncertainty, and inability to control emotions. The authors found that players with poor sleep quality had higher levels of confusion compared to those with good sleep quality. Furthermore, players who subsequently lost their match reported significantly higher rates of confusion and tension, which are also related to poor sleep quality. The athletes who slept well and won their games were found to have lower stress levels [28].
Parental experiences of the diagnosis of permanent childhood hearing loss: a phenomenological study
Published in International Journal of Audiology, 2020
Dunay Schmulian, Christopher Lind
1. Confusion, which we define as uncertainty about what is happening, or what is required was identified by all participants as one of the initial emotions they experienced. Participant 7a states that, at the diagnosis of profound bilateral hearing loss and when complex anatomical anomalies were identified during the early management process:“We got confused……until now we [were] still confused….less confused in terms of information, but more confused in term of what we should do next.” Participant 7a“It was confusing, so it was very confusing to know what to do, so it was all the ins and outs, I didn’t know what to do.” Participant 6b
A confusing manifestation: a case report of neurosarcoidosis presenting with confusion
Published in Journal of Community Hospital Internal Medicine Perspectives, 2018
Ateeq Mubarik, Syed Moin Hassan, Monicka Felix, Salman Muddassir, Furqan Haq
In a systematic review and meta analysis of 1088 patients of neurosarcoidosis the main presenting neurological symptoms were cranial nerve palsies (55%), headache (32%), sensory abnormalities like hypoaesthesia, paraesthesia, and neuropathic pain (29%) and gait abnormalities (28%). Visual impairment, hemiparesis and paraparesis, ataxia, vertigo, seizures, psychiatric symptoms, nystagmus and papilledema also occurred frequently [5]. Confusion without any other neurological symptoms, as was present in our patient, is a unique presenting symptom. It is present in sporadic case reports in combination with other neurological symptoms like hemiparesis and gait disturbances [14,15]. We used the Zajicek et al criteria to diagnose our patient with neurosarcoidosis [16]. This criteria divided neurosarcoidosis into confirmed neurosarcoidosis, probable neurosarcoidosis and possible neurosarcoidosis. Our patient fit the picture of probable neurosarcoidosis with clinical presentation of neurosarcoidosis with evidence of inflammation in the central nervous system, and evidence of systemic sarcoidosis and exclusion of other diseases. Marangoni et al. recently proposed some changes to the existing diagnostic criteria by adding a High Resolution computed tomography (HRCT) instead of a CXR and measuring the CD4/CD8 T cell ratio in the Cerebrospinal fluid (CSF) [17]. However, it is still unclear what the sensitivity and specificity of the diagnostic criteria of zajicek et al is and how manrangoni et al changes may affect the existing criteria.
Related Knowledge Centers
- Acute Stress Disorder
- Alcoholism
- Consciousness
- Delirium
- International Classification of Diseases
- Memory
- Dementia
- Pathology
- International Classification of Diseases
- Medical Subject Headings
- Orientation