Delirium secondary prevention

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Vishal Khurana, M.B.B.S., M.D. [2]; Pratik Bahekar, MBBS [3]

Overview

Delirium causes further complications that may worsen patient's condition. Secondary prevention plays important role in management of the delirium.

Secondary Prevention

The main complications of delirium are :

• Falls
• Pressure sores
• Nosocomial infections
• Functional impairment
• Continence problems
• Over sedation

Falls

Restraints are not effective in preventing falls, but ironically restrain may increase the risk of injury. The patient should be bedded on the floor or closer to the floor.

Pressure sores

The following strategies may be utilized to prevent and manage pressure sores,

• Formal pressure sore risk assessment ( e.g. Norton score, or Waterlow score)
• Regular pressure area care, including special mattresses where necessary
• Mobilization as soon as their illness allows.

Functional impairment

Physiotherapist and occupational therapist consult is beneficial to maximize recovery.

Continence

Issues related to continence may be managed by following guidelines,

• Continence assessment
• Regular toiletting
• Prompt treatment of UTI
• Avoid catheters as it may elevate risks of trauma in confused patients, and also UTIs.