Delirious distractions
Re-reading the chapter on Delirium in the “Harrison's Principles of internal Medicine” was a re-learning time. Delirium is defined as an acute confusional state, leading to major morbidity and mortality. The diagnosis is based on Confusion Assessment Method Diagnostic Algorithm. Two necessary criteria, and one of the other two as an additional criterion. Acute onset and fluctuating course – mental status changes, sudden in onset and fluctuates during the day. Inattention – difficulty in focussing attention, easily distractable or difficulty in keeping track of what is being said. Disorganised thinking – thinking is disorganised or incoherent, rambling, irrelevant, unclear, illogical, unpredictable. Altered Level of consciousness – not alert – either vigilant (hyperalert) lethargic (drowsy or easily aroused) or come (unarousable). Reading this was not only re-learning but revealing too. I suddenly realised, sometime during the day I am in Delirium too! And many around me too! Sudde