• Delirium is a symptom, not a diagnosis; the astute clinician must seek to discover and treat the underlying source of delirious states.

• It is a transient cognitive condition associated with decreased attention span and waxing and waning symptoms.

• Three types: (1) Hyperactive, (2) Hypoactive, (3) Mixed (daytime somnolence, nighttime agitation).

• In young patients, the cause is commonly due to toxins or trauma, while that for the elderly is typically infection or medication related.

• Five critical causes of delirium that must be recognized and treated immediately:

1. Hypoxia
2. Hypoglycemia
3. Central nervous System infections
4. Hypertensive encephalopathy
5. Increased intracranial pressure

References

• Smith J, Seirafi J. Delirium and Dementia. In: Marx J, Hockerberger R, Walls R, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. Phila: Mosby-Elsevier; 2006:1645-63.