Senin, 03 Februari 2014

Delirium: Impairment Awareness

Delirium is a temporary condition and usually occurs suddenly , in which patients experience a decreased ability to concentrate and become dazed , disoriented and unable to think clearly .

CAUSE

Delirium is an abnormal mental state , not a disease ; with a number of symptoms that indicate a decrease in mental function .

Various conditions or illnesses ( ranging from mild dehydration to drug toxicity or infection that can be fatal ) , can cause delirium .

This situation most often occurs in the elderly and patients who have suffered brain disorders , including severe sick people , people who consume drugs that cause changes in thoughts or behavior , and people suffering from dementia .

The cause of delirium :
# Alcohol , drugs and toxic materials
# The toxic effects of treatment
# Levels of electrolytes , salts and minerals (such as calcium , sodium or magnesium ) are not normal due to medication , dehydration or certain diseases
# Acute infection with fever
# Normal pressure hydrocephalus , which is a liquid that cushion the state where the brain does not properly absorbed and suppress brain
# Subdural hematoma , which is pooling of blood under the skull which can suppress the brain .
# Meningitis , encephalitis , syphilis ( infectious disease that attacks the brain )
# Lack of thiamine and vitamin B12
# Hypothyroidism and hypothyroidism
# Brain tumors ( some of which occasionally cause daze and impaired memory )
# Broken pelvis and long bones
# The function of the heart or lungs are bad and cause low oxygen levels or high levels of carbon dioxide in the blood
# Stroke .

SYMPTOMS

Delirium can be initiated by a variety of symptoms , and mild cases may be difficult to identify.
The behavior of someone who experienced delirium vary , but roughly the same as people who are experiencing severe hangover .

The main characteristic of delirium is not able to focus .
People can not concentrate , so they have difficulty in processing new information and can not remember the events that had just occurred .

Almost all patients experienced disorientation of time and confused with where they are.
Their minds messed up , delirious and occurs inkoherensia .

In severe cases , patients do not know themselves .
Some people experience paranoia and delusions ( believing that there was a strange things ) .

Patient response to the difficulties faced different ; there is a very quiet and withdrawn , while others become hyperactive and trying to fight hallucinations and delusions experienced.

If the cause is drugs , then often there is a change of behavior .
Drug toxicity causing the patient to sleep very quiet and withdrawn , whereas amphetamine poisoning causes people to be aggressive and hyperactive .

Delirium can last for hours , days or even longer, depending on the severity of symptoms and the patient's medical environment .
Delirium is often worse at night ( a phenomenon known as the sunset ) .
In the end , the patient will sleep restless and could develop into a coma ( depending on the cause ) .

Distinguishing Delirium With psychosis
Common Symptoms of Delirium 
(physical illness)
Common symptoms of psychosis 
(mental disorder) 
Confused about the time, date, place or identity 
Usually aware of the time, place and identity 
Difficult to concentrate 
Able to focus 
Forget the events that just happened 

Illogical thinking but remember that just happened peristisa
Not being able to think logically or perform simple calculations 
Able to perform simple calculations 
Fever or other signs of infection
Previous history of psychological disorders
Hallucinations (see) 
Hallucinations (hearing) 
There is evidence of drug use
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Tremor
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Diagnosis 

Diagnosis based on symptoms and the cause determined as soon as possible. 

Do a complete physical examination and focused on patients with neurological responses. 

Other examination is commonly performed blood tests, x-rays and lumbar puncture. 

TREATMENT 

Treatment depends on the cause; 
- Infection treated with antibiotics 
- Fever treated with medication for fever 
- Abnormal levels of salts and minerals in the blood solved by setting the fluid and salt levels in the blood. 

To alleviate agitation administered drugs benzodiazepines (eg, diazepam, triazolam and temazepam). 

Anti-psychosis drugs (eg, haloperidol, and chlorpromazine tioridazin) is usually given only to patients who are paranoid or terrified or patients who can not be appeased with benzodiazepines. 

If the cause is alcohol, benzodiazepines administered until the patient lost agitation. (Medicastore)