The 5 ideas key:
1. The
authors propose that diagnostic and management strategies differ based on (1)
potential reversibility and (2) delirium subtype.
2.
Pharmacological interventions: The medications used to control agitation or
other symptoms associated with delirium can be rapidly
and safely using a ‘titration technique’ based on each medication’s
pharmacokinetics, in the same manner that opioids are titrated rapidly and
safely to control pain.
3.
Nonpharmacological approaches: Ensure patients have good nutrition and an effective
bowel and bladder management strategy. Monitor fluid intake. Rehydrate with
oral fluids containing salt, e.g., soups, sports drinks, red vegetable juices.
When necessary, infuse fluids subcutaneously rather than intravenously.
4. Family
and Caregiver Education and Support: Caregivers can be instrumental in helping
to prevent, identify, and treat delirium. If taught the signs and symptoms of
delirium, caregivers may alert the medical team to need for immediate
follow-up.
5. With
these combined approaches, clinicians can rapidly control the agitation and
other symptoms associated with delirium and relieve patient and family
distress.
Publicat per Teresa Font
