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Delirium: Treatment Management of delirium begins with treatment of the underlying inciting factor (e.g., patients with systemic infections should be given appropriate antibiotics and underlying electrolyte disturbances judiciously corrected). These treatments often lead to prompt resolution of delirium. Blindly targeting the symptoms of delirium pharmacologically only serves to prolong the time patients remain in the confused state and may mask important diagnostic information. Relatively simple methods of supportive care can be highly effective in treating patients with delirium. Reorientation by the nursing staff and family combined with visible clocks, calendars, and outside-facing windows can reduce confusion. Sensory isolation should be prevented. | Chapter 026. Confusion and Delirium Part 7 Delirium Treatment Management of delirium begins with treatment of the underlying inciting factor e.g. patients with systemic infections should be given appropriate antibiotics and underlying electrolyte disturbances judiciously corrected . These treatments often lead to prompt resolution of delirium. Blindly targeting the symptoms of delirium pharmacologically only serves to prolong the time patients remain in the confused state and may mask important diagnostic information. Relatively simple methods of supportive care can be highly effective in treating patients with delirium. Reorientation by the nursing staff and family combined with visible clocks calendars and outside-facing windows can reduce confusion. Sensory isolation should be prevented by providing glasses and hearing aids to those patients who need them. Sundowning can be addressed to a large extent through vigilance to appropriate sleep-wake cycles. During the day a well- lit room should be accompanied by activities or exercises to prevent napping. At night a quiet dark environment with limited interruptions by staff can assure proper rest. These sleep-wake cycle interventions are especially important in the ICU setting as the usual constant 24-h activity commonly provokes delirium. Attempting to mimic the home environment as much as possible has also been shown to help treat and even prevent delirium. Visits from friends and family throughout the day minimize the anxiety associated with the constant flow of new faces of staff and physicians. Allowing hospitalized patients to have access to home bedding clothing and nightstand objects makes the hospital environment less foreign and therefore less confusing. Simple standard nursing practices such as maintaining proper nutrition and volume status as well as managing incontinence and skin breakdown also help to alleviate discomfort and resulting confusion. In some instances patients pose a threat to their own .
