(Delrium)

COMMON CAUSES Mnemonic- ‘MIST’ (within brackets pointers to diagnosis)

Treatment:-

Most often guided by the cause of the acute confusional state. Points to remember:- Any acute confusional state-

·       ABC is first, start a line and collect blood for the routine investigations,

·       Consider “Antidotes” = GOT FAN- Glucose, Oxygen, Thiamine, Flumazenil, Antropine, Naloxone

·       Glucometer reading of whole blood glucose,

·       IV bolus of 50% dextrose 25ml (in a non-alcoholic) or high dose Thiamine (100mg bolus)followed by any kind of glucose containing solutions in a known alcoholic.

·       For    Alcoholic    delirium    tremens    add     on           Chlordiazepoxide         (Librium) 50/100mg/day in divideddosage.

·       If patient is restless and likely to cause harm to himself and others, use haloperidol 1mg-2.5mg as needed, IM.