Week 4 ICU Delirium
ICU Delirium
I found an article titled “their altered mental states: the confusion of delirium.” This was a magazine article from 2007 published in U.S. News & World report. Whose summary concludes with a quote from Wesley Ely, a critical-care specialist who founded the ICU Delirium and Cognitive Impairment Study Group at Vanderbilt University School of Medicine. Mr. Ely introduces the Idea that “Delirium is a predictor of death, a longer hospital stay, and increased costs.” This article episodes of delirium are not uncommon in the ICU, particularly amongst the elderly. Delirium is not always apparent and can present as simply as disorientation or inattentiveness.
We learned from the video that we watched as instructed for the class, that often times patients, while having episodes of delirium can feel as if they are being bound, and/or incarcerated. These patients describe a confused longing to be set free from whatever they perceive as binding them. Having never experienced this myself, I can only imagine the feeling as exaggeratedly unpleasant to the patient and, as is mentioned in this article “enormously distressing to the families.” Furthermore, researchers have unearthed evidence that “sun-downing,” as delirium states are nicknamed because of their timing, may be far from benign and could have lasting effects. We learn that sedated and ventilated patients are far more vulnerable to these delirium-like states. These patients are also likely to experience increased instances of pneumonia, infection, low blood oxygen, a specific drug or combination of medications, too much fluid in the body, and out-of-balance electrolytes.
I agree with the author in that these patients are confused and can be re-oriented to their situation. The medical staff as well as visiting friends and family can intervene crucially by continually reminding patients where they are and what is going on. Anything that can be brought into the ICU such as stuffed animals or bedside clocks can help to keep the patient oriented to time and place as well. Psychiatric consultation is often employed in efforts to find the root causes of delirium states as intervening physicians can be often too focused on the reasons for the hospitalization rather than the resulting delirium states. Findings during cognitive functioning examination may indicate the need for further mental health screening (Zator Estes, 2010, p. 713).
References
Baldauf, S. (2007). Their altered mental states: The confusion of delirium. U.S. News & World Report, 143(3), 64.
Zator Estes, M. (2010). Health assessment and physical examination (4th ed.). Vienna, Virginia: Delmar.
