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Reducing the Risks of Delirium- From the Field to the Hospital. Susan Schumacher, MS, APRN-BC. What is Delirium?. Acute, fluctuating disturbance of consciousness, attention, cognition, and perception, that can affect sleep, psychomotor activity, and emotions.

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reducing the risks of delirium from the field to the hospital

Reducing the Risks of Delirium- From the Field to the Hospital

Susan Schumacher, MS, APRN-BC

what is delirium
What is Delirium?
  • Acute, fluctuating disturbance of consciousness, attention, cognition, and perception, that can affect sleep, psychomotor activity, and emotions.
    • (Allen,KR., Fosnight, SM et.al, 2011)
incidence and outcomes related to hospital acquired delirium
Incidence and Outcomes Related to Hospital-Acquired Delirium
  • 2.3 million Americans develop delirium every year
  • 5-61% of orthopedic patients annually; hip fracture patients highest incidence
  • 18% of patients who develop delirium do not have resolution 6 months after discharge
  • 50% of patients die within 1 year
risk factors for developing delirium
Risk Factors for Developing Delirium
  • Dementia, Parkinson’s Disease, past delirium
  • Pain
  • Sensory Deficits (macular degeneration, hearing loss)
  • Medications (polypharmacy and/or certain drugs)
  • Hypoxia
  • Sleep deprivation
  • Dehydration (fluid/electrolyte imbalance)
  • Nutritional status
  • Infections
what s the role of ems personnel
What’s the Role of EMS personnel?
  • If patient has Sensory Deficits:
    • Bring glasses and/or hearing aids to Emergency Center
    • Encourage patient to wear
    • If family member questions why these items should be taken to hospital, please communicate the importance of patient being able to see and hear information provided by hospital staff.
what s the role of ems personnel1
What’s the Role of EMS personnel?
  • Medications that increase risk of Delirium:
  • 1. Benzodiazepines (ie., Ativan)
  • 2. Antihistamines (ie.,Benadryl)
  • 3. Narcotics (ie., Morphine, Demerol)
  • 4. Hydroxyzine (Vistaril)
  • There are appropriate uses for any of these medications for older patients, however it’s important to understand their risks in leading to delirium.
  • Minnesota Hospital Association- LEAPT (Leading Edge Advanced Practice Topic) for Reducing Delirium