Myth: Sedatives (like benzos) are mostly helpful in calming delirium. Fact: Sedatives often worsen delirium. Non-drug approaches (reorientation, hydration, mobility) are first-line treatments.
Christina
@christinaj1956.bsky.social
Retired ICU nurse, research manager for ICUsteps. Interested in rehabilitation after critical illness
📢 Shoutout for potential participants for my post-reg MSc dissertation focus group. I am looking for UK&Irish #OccupationalTherapists working with inpatient in #criticalcare who have #neurocognitive impariments. Please get in contact if you meet the criteria via deatails below! #icurehab
More than 1 in 3 older inpatients in this study were dehydrated. Dehydrated patients: 13% higher odds of falling (OR 1.13, P=.002). ↳ Dehydration is cheap to fix - but easy to miss. 💧💧💧💧💧💧💧💧 ⇉ Do you check fluid status on every ward round?
Always, always ask: Why is this person delirious? If they are showing agitation - always check for pain, retention, constipation, thirst, etc. #Delirium #PatientSafety #Geriatrics #MedEd #Pain #Hospitalist #EmergencyMedicine #InternalMedicine #Dementia
“Nobody used the word delirium. I thought I’d lost my mind.” — Delirium survivor ➡️ Always provide clear information, including telling the patient they have delirium, during the episode. Then explain & de-brief afterwards.
Family members concerned that their relative in hospital has delirium should assertively approach healthcare professionals and say, ""I think my relative has delirium." Unfortunately #delirium is still missed, and informed families play an important role in advocating for their loved ones.
"I can't remember" – Patients who have had #delirium often experience a feeling of 'lost time'. You can help by clearly explaining what delirium is & answering their questions. Give them a narrative of what has happened to them.
When a person in hospital is restless then it often means they are experiencing #delirium. → Look carefully at their facial expressions - see if they might be seeing things that are not real. → Sometimes asking them - "are you seeing anything strange or frightening?" can help.
Families: Caring for someone with #delirium is exhausting. Your wellbeing matters too. Take breaks, seek support, ask for help.
We all should be using tools to detect #delirium. But not all tools perform well in practice - some show much lower rates of detection in the real-world than in practice. -- check tool performance -- it's not enough to implement & achieve good completion rates.
The most effective treatment for delirium is to find the causes & manage these. Haloperidol is way overused, and in fact should only be used in a tiny minority of patients, especially outside of the ICU. #delirium
2 millenia & counting. Hippocrates knew #delirium was a medical emergency. Why is it still so often missed, misdiagnosed, or undertreated? What are the barriers? What are the solutions?
Families sometimes report feeling guilty when their loved one has #delirium but it has been missed. The truth is that most members of the public haven't been informed about what delirium is or how to spot it. We need a public health awareness campaign on delirium.
⭐ META-ANALYSIS: Hospital delirium --> devastating long-term outcomes 253 studies, 137,000+ pts: • 5.4x dementia risk • 2.8x institutionalisation • 2.5x mortality • 1.7x readmission ⚠️ Delirium = a serious acute problem AND a risk warning. ➡️ All pts deserve robust delirium assessment
Delirium isn't always preventable. But this cascade? Early recognition likely changes the trajectory. #delirium
Life is so very short. Go where you want to go, and spend time with those people you love, and who love you back. Your inner peace is priceless. When you survive a critical illness, you see things very clearly.
🧠 Delirium is the only dedicated delirium journals 👍100% open access. 👍Ultra-low fees ($20 submission, $280 publication). 👍All study types welcome & rapid 4-week peer review. #delirium
Shocking reality: 1 in 4 older hospital patients develop #delirium, yet most families have never heard the word. We need to do much better in improving public awareness of delirium.
Mrs Smith, 78, hip fracture patient, described as "confused & aggressive" Ward round note: "?UTI. Start antibiotics." No mention of "delirium" My reaction: What about her distress - untreated pain? Dehydration? Medication review? Telling the family the diagnosis? Etc. Why we need Delirium 8 👇
When you're with a patient with #delirium, imagine that you're them. Delirium survivor: 'get down on the eye level with your patient, take a hand if it's appropriate and just say your name and who you are.'
🧠 💻 Have you completed our learning modules? Module one covers Assessment of the #CriticallyIll patient, referral to #CriticalCare, #Sedation and #Analgesia and much more. Find out more 🔗 www.scottishintensiv... #IntensiveCare #IntensiveCareSociety
Have experience of a loved one in ICU follow a traumatic brain injury (TBI)? Open to talking about your experience? Contact Maggie to find out more, & contribute to this valuable research that will help us improve how we look after families through this very difficult time 🧡 Shares appreciated 🙏
