Lee Sangil, Angel Clay, Han Jin H
Department of Emergency Medicine, The University of Iowa Carver College of Medicine, Iowa City, IA USA.
Department of Hospital Medicine, Kaiser Permanente San Jose Medical Center, San Jose, CA USA.
Curr Emerg Hosp Med Rep. 2021;9(2):11-18. doi: 10.1007/s40138-021-00226-9. Epub 2021 Mar 18.
This study aims to provide a concise delirium review for practicing emergency medicine providers using the Assess, Diagnose, Evaluate, Prevent, and Treat (ADEPT) framework.
Delirium is a form of acute brain dysfunction that results in significant mortality and morbidity for older emergency department (ED) patients. Delirium is frequently missed by healthcare providers, but monitoring for this syndrome using brief delirium assessments may improve recognition. Once delirium is diagnosed, emergency medicine providers' primary goal is to perform a comprehensive history and physical examination to uncover the underlying etiology for delirium. This includes obtaining history from a collateral historian and obtaining an accurate medication history. If posssible, emergency physicians (EPs) should treat the medical etiology that precipitated the delirium. If agitated, non-pharmacologic interventions such that minimize the use of tethers are preferred. Pharmacologic agents such as antipsychotic medications should be used as a last resort.
Delirium is a common geriatric emergency and requires the EP to assess, diagnose, evaluate, prevent, and treat. Delirium is a key geriatric syndrome that geriatric ED providers should routinely screen for. A strong emphasis is on the widespread use of delirium screening, followed by prevention and treatment efforts.
本研究旨在使用评估、诊断、评估、预防和治疗（ADEPT）框架，为从事急诊医学的医护人员提供一份简明的谵妄综述。
谵妄是一种急性脑功能障碍形式，会给老年急诊科患者带来显著的死亡率和发病率。医护人员常常漏诊谵妄，但使用简短的谵妄评估来监测这种综合征可能会提高识别率。一旦诊断出谵妄，急诊医学医护人员的主要目标是进行全面的病史采集和体格检查，以找出谵妄的潜在病因。这包括从旁证者处获取病史并获取准确的用药史。如果可能，急诊医生应治疗引发谵妄的医学病因。如果患者烦躁不安，首选尽量减少使用约束措施的非药物干预。抗精神病药物等药物应作为最后手段使用。
谵妄是一种常见的老年急诊情况，需要急诊医生进行评估、诊断、评估、预防和治疗。谵妄是一种关键的老年综合征，老年急诊科医护人员应常规筛查。重点强调广泛使用谵妄筛查，随后进行预防和治疗工作。
