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Core EM - Emergency Medicine Podcast

Episode 29.0 – Dementia, Delirium and Ischemic CVA

Jan 11, 2016
Explore the critical differences between delirium and dementia, especially in the emergency department. Learn about efficient screening methods and the importance of accurate diagnosis. The discussion delves into ischemic stroke management, emphasizing blood pressure control and thrombolytic treatments. Discover effective communication strategies for discussing tPA treatment, focusing on balancing risks and benefits. This episode is a must-listen for anyone interested in improving patient outcomes in acute settings.
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INSIGHT

Delirium Is Often Missed in ED

  • Delirium is often misdiagnosed in emergency departments, with rates of 50 to 80% misdiagnosis.
  • Identifying delirium is crucial as it is common among elderly ED patients and linked to higher mortality.
ADVICE

Use BCAM to Screen Delirium Fast

  • Use the brief confusion assessment method (BCAM) to quickly screen for delirium in under two minutes.
  • The four-step BCAM includes assessing mental status, attention, consciousness, and thought organization.
ADVICE

Thyroid Workup Important in Delirium

  • Conduct basic diagnostic workup for delirium including vital signs, electrolytes, non-contrast head CT, infection screening, and TSH.
  • Do not overlook thyroid disease as both hypothyroidism and hyperthyroidism can cause delirium.
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