Acute Confusion (OSCE)
Jump to navigation
Jump to search
History Taking for the Onset of Acute Confusion
Major and Minor Criteria[edit | edit source]
- diagnosis of delirium requires both major plus any one minor criteria
- Can remember the criteria using the mnemonic AIDS:
Major[edit | edit source]
- Acute onset and fluctuating course
- Disorder of attention (inattention)
Minor[edit | edit source]
- Disorganized thinking
- Alterations in sensorium (e.g. visual or auditory hallucinations)
Patient ID[edit | edit source]
CC[edit | edit source]
- need several iterations of the history, from several caregivers (may have large inter-observer differences in opinion)
HPI[edit | edit source]
- onset
- acute (<2-3 months)
- chronic (> 3 months represents a dementing state)
- progress
- gradual decline, static, rate of fluctuation
- palliating
- precipitating
- quality
- AIDS
- altered LOC
- disorientation
- memory
- psychomotor agitation/retardation
- altered sleep-wake cycle
- severity
- ADL → getting out of bed, using the bathroom, dressing, ambulation
- IADL → cooking, laundry, shopping, banking, paying bills, driving
- safety concerns
- cognitive function (MMSE)
- symptoms
- behaviour changes - agitation
- SAH → thunderclap headache
- stroke → aphasia, paralysis
- UTI → dysuria
- pneumonia → cyanosis, cough, sputum, fever
Medications[edit | edit source]
- benzodiazepines
- beta-blockers
- anticholinergics
PMHx[edit | edit source]
- trauma
- stroke
- CAD
- endocrinopathy
- kidney
- psych
FMHx[edit | edit source]
- dementia
- depression
SHx[edit | edit source]
- EtOH
- social support (caregiver stress), living arrangements
ROS[edit | edit source]
- sleep pattern
- visual changes
- hearing loss
- constipation
- incontinence