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To manage delirium, two pathways are followed at the same time: one to deal with the behavior problems, and another to identify and treat the medical disorder that causes them. A key point to remember is that delirium symptoms can last for a long time, even after the causes and risk factors are resolved.
Delirium is a common acute state of confusion observed in critically ill patients and is associated with adverse short-term and long-term outcomes. Assessing the risk of delirium involves considering both predisposing and precipitating factors. The presence of multiple predisposing factors lowers the threshold for delirium onset, requiring fewer precipitating factors.
Accurate diagnosis is essential for effective delirium management. Using a validated instrument such as the Confusion Assessment Method algorithm is recommended to assess relevant features. Once diagnosed, patients undergo a comprehensive evaluation to identify and address any reversible causes contributing to delirium. Nonpharmacological interventions are the preferred approach for managing behavioral disturbances, reserving medication usage for situations where patient safety is at risk. In such cases, low doses of high-potency antipsychotic agents are often used as the off-label treatment, targeting specific behaviors and discontinuing use as soon as possible.