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sábado, 3 de septiembre de 2016

Dementia in the ED

emDocs - September  1, 2016 - Author: Kay Coleman D - Edited by: Koyfman A and Long B
"Pearls
  • Delirium is more acute in onset, fluctuates more frequently and drastically, and includes alterations in consciousness and perception; dementia induces a more gradual and steady decline and symptoms are predominantly impairments in memory and cognitive function.
  • Common reversible causes of dementia include drugs (either overdose or poly-pharmacy), depression, metabolic or endocrine disorders, hydrocephalus, space-occupying lesions, decline in hearing or vision, infections, or anemia.
  • Patients presenting with symptoms of dementia should be evaluated with CBC, chemistry, LFTs, TSH, and CT head to help identify reversible causes; not all reversible causes will be identified in the emergency department because they require further outpatient evaluation for diagnosis (such as depression or decline in hearing).
  • Any patient who cannot ambulate or perform their activities of daily living and who does not have family able to care for them at home will require placement in a nursing home or institution; contact your social workers to see if this can be arranged from the emergency department."