Praxis
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Acute confusional state, delirium, occurs in up to 80% of patients in the intensive care unit and is also a common, life-threatening and potentially preventable clinical syndrome among persons who are 65 years of age or older in general hospital. The cause of acute confusional state is typically multifactorial. Delirium and dementia are highly interrelated and dementia is the leading risk factor for delirium. ⋯ First nonpharmacologic approaches should be instituted, including a calm, comfortable environment with the use of orienting influences. Pharmacologic management should be reserved for patients whose symptoms would threaten their own safety or the safety of other persons. Therapeutic drug options include modern antidepressants and neuroleptics.