Rapid Fire : Acute Brain Failure in Older Emergency Department Patients - 14/04/21

Doi : 10.1016/j.emc.2020.12.002

Debra Eagles, MD, MSc ^a,^b,^c,^⁎ , Danya Khoujah, MBBS, MEHP ^d,^e,^{^{1
Present address: 110 S Paca St, 6th Floor, Suite 200, Baltimore, MD 21201, USA}}
^a Department of Emergency Medicine, University of Ottawa, Ottawa, Ontario, Canada
^b School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
^c Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
^d Emergency Medicine, MedStar Franklin Square Medical Center, 9000 Franklin Square Dr, Baltimore, MD 21237, USA
^e Department of Emergency Medicine, University of Maryland School of Medicine, Baltimore, MD, USA

^∗Corresponding author. Epidemiology Program, The Ottawa Hospital, Civic Campus, F658a, 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9, Canada.Epidemiology ProgramThe Ottawa HospitalCivic CampusF658a, 1053 Carling AvenueOttawaOntarioK1Y 4E9Canada

Résumé

Delirium is common in older emergency department (ED) patients. Although associated with significant morbidity and mortality, it often goes unrecognized. A consistent approach to evaluation of mental status, including use of validated tools, is key to diagnosing delirium. Identification of the precipitating event requires thorough evaluation, including detailed history, medication reconciliation, physical examination, and medical work-up, for causes of delirium. Management is aimed at identifying and treating the underlying cause. Meaningful improvements in delirium care can be achieved when prevention, identification, and management of older delirious ED patients is integrated by physicians and corresponding frameworks implemented at the health system level.

Le texte complet de cet article est disponible en PDF.

Keywords : Emergency department, Delirium, Mental status, Screening, Infection, Polypharmacy