ICU SAQs · Sedation & paralysis
ICU delirium — screening, prevention and management
A CICM Second-Part SAQ on ICU delirium — the CAM-ICU screening, the prevention bundle (light sedation, early mobility, sleep, benzodiazepine minimisation), the principle of finding and treating the cause, and dexmedetomidine as the preferred drug.
On this page
Study tools
Target exams
CICMFFICMEDIC
Prompt
A ventilated ICU patient is found to have delirium on screening. Outline how delirium is defined and screened, the prevention bundle, and your management — including the role of dexmedetomidine and the limits of antipsychotics.
Question
A ventilated ICU patient is found to have delirium on screening. Outline how delirium is defined and screened, the prevention bundle, and your management — including the role of dexmedetomidine and the limits of antipsychotics.
[1]References4ShowHide
- [1]Devlin JW, Skrobik Y, Gélinas C, et al. Clinical Practice Guidelines for the Prevention and Management of Pain, Agitation/Sedation, Delirium, Immobility, and Sleep Disruption in Adult Patients in the ICU (PADIS). Critical Care Medicine, 2018.PMID 30113379
- [3]Riker RR, Shehabi Y, Bokesch PM, et al. Dexmedetomidine vs midazolam for sedation of critically ill patients: a randomized trial (SEDCOM). JAMA, 2009.PMID 19188334
- [8]Girard TD, Exline MC, Carson SS, et al. Haloperidol and Ziprasidone for Treatment of Delirium in Critical Illness N Engl J Med, 2018.PMID 30346242
- [13]Chen TJ, Chung YW, Chang HR, et al. Diagnostic accuracy of the CAM-ICU and ICDSC in detecting intensive care unit delirium: A bivariate meta-analysis Int J Nurs Stud, 2021.PMID 33120134