Stabilizing and Managing Patients with Altered Mental Status and Delirium - 21/10/15

Doi : 10.1016/j.emc.2015.07.004

Ebelechukwu A. Odiari, MD ^a,^⁎ , Navdeep Sekhon, MD ^b, Jin Y. Han, MD ^c, Elizabeth H. David, MD ^c
^a Section of Emergency Medicine, Baylor College of Medicine, 1504 Taub Loop, Houston, TX 77030, USA
^b Section of Emergency Medicine, Baylor College of Medicine, 439 Jackson Hill Street, Houston, TX 77007, USA
^c Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, 1502 Taub Loop, NPC Building 2nd Floor, Houston, TX 77030, USA

^∗Corresponding author.

Résumé

Present in all patient populations, altered mental status (AMS) is a common, but nonspecific emergency department (ED) presentation that can signify serious underlying pathology. Delirium is a more defined mental status change caused by another medical condition that carries a high morbidity and mortality if missed. However, ED physicians miss the condition in more than 50% of cases. The ED physician should maintain a high index of suspicion for delirium, because if missed in the ED, delirium is more likely to be missed on the floors as well. Management of delirium is directed toward treating the underlying course.

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Keywords : Altered mental status, Delirium, Emergency department, Management, Antipsychotics