ICU Delirium

The article I read “Incidence, Risk Factors and Consequences of ICU Delirium” stated they found a 30% incidence of delirium as opposed to previous reports of 80%. Excess use of sedatives lengthens time spent on a ventilator and prolongs hospital stays. According to this study patients were evaluated with the 8-item Intensive Care Delirium Screening Checklist (ICDSC) and level of sedation was measured with the Richmond Agitation and Sedation Scale (RASS). According to the article delirium has been term an “organ failure” of the brain resulting from severe systemic disease (Ouimet, et al. 2007). Patients were screened for a plethora of pre-existing diagnoses, and found that as well as those with alcoholism and hypertension had the highest incidence of delirium.  Drug induced comas also has a high incidence of delirium.   All patients in the study were assessed daily and followed until either death or discharge.  I think it is amazing how many patients suffer from ICU delirium.  I have not spent much time in the ICU however when I did my nursing school rotation and the pt was under light sedation and on a ventilator.  I never once see them implement the CAM –ICU Sedation Scale or any other scale nor was the RASS used.  So I see how ICU delirium can go undetected in a patient.  The ICU nurse was doing a lot for the patient so I do not want to come across as she was not doing her job I am just relating my experience.  The first stage is recognizing ICU delirium as an issue before solutions can be implemented. Which hopefully will educate ICU nurses of the incidence in delirium and preventative measures or interventions implemented I think the part I found most interesting was that according to the article hypertension and alcoholism were the leading comorbidities to developing ICU delirium.

 

Reference:

Ouimet, S. , Kavanagh, B. , Gottfried, S. , & Skrobik, Y. (2007). Incidence, risk factors and consequences of icu delirium. Intensive Care Medicine, 33(1), 66-73.