Can you do anything to PREVENT delirium from developing in the ED?
Do what you can to minimize delirium in your ED:
- provide food and drink
- promote mobility
- minimize restraints
- maximize familiar faces and orientation
Many of our older patients stay in the ED for >8 hours. They are at significant risk for developing a confusional state especially if they:
- Already have some dementia
- Are sleep deprived (the patient in the hallway over night)
- Are immobilized (an O2 sat monitor and a Foley may not seem like restraints to you but for sure that patient is not going to get out of bed – do they really need those interventions?
- Are visually impaired (the glasses were left at home)
- Are hearing impaired (EMS didn’t bring the hearing aid for fear it would get lost)
- Are Dehydrated (the only patient who needs to be NPO is one who is going to have surgery within the next 6 hours or who is actively vomiting – but how often is NPO the default position in your department?)