CHAMPIncident Delirium in theHospitalized Senior.ppt

CHAMPIncident Delirium in the Hospitalized Senior Andrea Bial, MD Don Scott, MD, MHS University of Chicago Goals Facilitate learning and teaching around the topic: “Incident Delirium in Hospitalized Seniors” Reduce the Incidence of Delirium in Hospitalized Seniors Improve the Care of Hospitalized Seniors who develop Delirium ObjectivesSection 1 (Don) Learn More Teach More About Assessing Risk for Delirium Predicting Older Patients Probability of Developing Delirium Learn More Teach More About Delirium Prevention Strategies Avoiding Precipitants Prevention Interventions Learn More Teach More About Diagnosing Delirium: Using the Confusion Assessment Method (CAM) To Diagnose Delirium To Help Distinguish from Dementia ObjectivesSection 2 (Andrea) Learn More and Teach More about the Systematic Approach to the Evaluation of the Hospitalized Senior with Delirium Learn More and Teach More about the Systematic Approach for the Treatment of the Hospitalized Senior with Agitated Delirium HPI: Mrs. G., 87 y.o. woman from home; 4-5 days c fever, cough, malaise, ?appetite, ?po; 1 day ? DOE PHx: DM c neuropathy, HTN, A-Fib, OA, Glaucoma, COPD Meds: glipizide, amitriptyline qhs, lisinopril, Digoxin, Vioxx, T#3’s prn, Warfarin, Ditropan Soc / Fx Hx: Lives with husband, retired teacher, Ind. in ADLs and IADL’s PEx Vitals 381; 155/90,HR 105, RR 20; O2 94% RA, Non-Toxic HEENT: edentulous, dry OP Chest: ? BS and Exp Wheezes CV: Syst. M c/w SEM Abd: Benign; g- Ext’s: Trace Pedal Edema Neuro: AO X 3, Non-Lateralizing, follows commands U/A: 20 WBC, +LE / N, Many Bacteria U Bld Cx’s P CXR: + COPD Changes / ?RLL Infiltrate ECG: A-Fib @ 105 Teaching about Delirium in Hospitalized Seniors Teaching Opportunities for: Evidence-Based: Risk Factors for Delirium at Admission? Prediction of Delirium at Admission? Delirium-Producing Insults? Validated Prediction Tool for Delirium? Differentiati