Links To The IBCC Chapter, Delirium-This Chapter Is Also An Excellent Resource On Medication Treatment Of Delirium

Today, I reviewed and link to The Internet Book Of Critical Care Chapter [TOC], Delirium, October 11, 2021 by Dr. Josh Farkas.

Here are the links to the above resource.

Pitfalls

  • DO NOT treat agitated delirium with a benzodiazepine.  This will suppress symptoms temporarily, but will eventually make the delirium worse.
  • Avoid benzodiazepines in general, with certain very specific exceptions (chronic benzodiazepine use, status epilepticus).  The practice of using lorazepam for insomnia needs to be abolished.
  • Don’t overlook the cause of delirium, especially when it represents a dramatic neurologic change in a patient without any neurologic history.  It may be the manifestation of a severe disease process (e.g. subdural hematoma, sepsis).
  • Don’t treat elderly, multimorbid ICU patients with the same doses of antipsychotic that you would use for a young psychotic patient.  When feasible, start low and titrate to effect.

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