Purpose Of Review: Emergency departments (EDs) are facing an epidemic of overcrowding and ED boarding, particularly of older adults who often present with, or develop, delirium in the ED. Delirium is associated with increased complications, longer hospital length of stay, mortality, and costs to the healthcare system. However, we only have limited knowledge of how to successfully prevent and treat delirium in the ED in a pragmatic, sustainable, and cost-effective way. We present a narrative review of recent literature of delirium prevention and treatment programs in the ED. We aim to describe the components of successful delirium management strategies to be used by EDs in building delirium management programs.
Recent Findings: We reviewed 10 studies (2005-2023) that report delirium interventions in the ED, and describe the different components of these interventions that have been studied. These interventions included: optimizing hemodynamics and oxygenation, treating pain, hydration and nutrition support, avoiding sedative hypnotics, antipsychotics and anticholinergics, promoting sleep, sensory stimulation, limiting the time spent in the ED, educating providers and staff, and developing multidisciplinary delirium protocols integrated into the electronic health record.
Summary: Through our narrative review of the recent literature on delirium prevention and treatment programs in the ED, we have identified nine components of successful delirium prevention strategies in the ED. We also discuss three high priority areas for further research including identification of most effective components of delirium prevention strategies, conduct of additional high-quality trials in non-hip.
Download full-text PDF |
Source |
---|---|
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11156174 | PMC |
http://dx.doi.org/10.1007/s13670-024-00413-y | DOI Listing |
Nurs Crit Care
January 2025
Department of Critical Care Medicine, Shenzhen Nanshan People's Hospital and the 6th Affiliated Hospital of Shenzhen University Health Science Center, Shenzhen, China.
Background: Coronary care unit (CCU) patients surviving to discharge still face significant mortality. Delirium is common in CCU patients and has been associated with poorer CCU and in-hospital outcomes.
Aim: To assess the association between delirium and mortality after hospital discharge in CCU survivors.
Eur J Pediatr
January 2025
School of Nursing, College of Nursing, Taipei Medical University, Xinyi Dist, No. 250, Wuxing St, Taipei, 110, Taiwan.
Unlabelled: This study has the objective to translate the Cornell Assessment of Pediatric Delirium (CAPD) into Indonesian and evaluate the psychometric properties and diagnostic accuracy of the Indonesian version of the CAPD (I-CAPD) in identifying delirium in critically ill children. This prospective methodological study was conducted between January and April 2024 in a 6-bed pediatric intensive care unit (PICU). In total, 90 children aged 0-18 years hospitalized in the PICU were included.
View Article and Find Full Text PDFNurs Rep
December 2024
Division of Pulmonary, Critical Care and Sleep Medicine, UC San Diego Health, La Jolla, CA 92093, USA.
Although delirium is common during critical illness, standard-of-care detection and prevention practices in real-world intensive care unit (ICU) settings remain inconsistent, often due to a lack of provider education. Despite availability for over 20 years of validated delirium screening tools such as the Confusion Assessment Method in the ICU (CAM-ICU), feasible and rigorous educational efforts continue to be needed to address persistent delirium standard-of-care practice gaps. Spanning an 8-month quality improvement project period, our single-ICU interdisciplinary effort involved delivery of CAM-ICU pocket cards to bedside nurses, and lectures by experienced champions that included a live delirium detection demonstration using the CAM-ICU, and a comprehensive discussion of evidence-based delirium prevention strategies (e.
View Article and Find Full Text PDFTrauma Surg Acute Care Open
January 2025
Department of Emergency and Critical Care Medicine, Nippon Medical School, Bunkyo-ku, Tokyo 1138603, Japan.
Background: Patients with cervical spinal cord injuries (CSCIs) have a high incidence of respiratory complications. The effectiveness of non-invasive positive pressure ventilation (NPPV) in preventing respiratory complications such as pneumonia in acute CSCIs remains unclear. We evaluated whether intermittent NPPV (iNPPV) could prevent pneumonia in patients with acute CSCIs.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Department of Neurological Surgery, Oregon Health & Science University, Portland, OR, USA.
Deep brain stimulation (DBS) is a valuable treatment for Parkinson's disease (PD), but postoperative delirium (POD) is a common complication. Understanding the risk factors for POD is crucial for optimizing patient selection and developing preventative measures. This systematic review and meta-analysis aims to identify predictors of POD in PD patients undergoing DBS surgery.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!