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lunes, 10 de octubre de 2016

Acutely Confused Elderly Patient

EM Didactic - By Lakshay Chanana - October 10, 2016
"Patients presenting to the ED with an Altered Mental Status (AMS) require a thorough history and an extensive work-up leading to time consuming evaluation, talking with families and caregivers, reviewing old records, labs and radiologic studies. Even after an broad work up, occasionally a diagnosis is not reached. It becomes a challenge for emergency physicians to work with limited history and examination findings. Therefore, adopting an organized approach to the evaluation of mental status would result in increased clinician comfort while taking care of elderly, better ability to communicate with other physicians, and improved patient and family satisfaction...

Take Home: 
  • When evaluating delirium, do a through history and physical and ask for medications and also over the counter prescriptions. 
  • Identify and treat life threats first. 
  • Do not underestimate the role of family or nursing home staff who can better detect a change in the patient’s cognition. Be extremely sensitive while dealing with the family."