Delirium in children and adolescents

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Target exams

Red flags

• Acute fluctuating disturbance of attention and awareness in an ill child — do not dismiss as agitation or behavioural disturbance; screen with CAPD and investigate the underlying cause
• Hypoactive delirium is the commonest and most-missed subtype in PICU — a child who is 'quiet and comfortable' may be acutely delirious and needs active screening, not reassurance
• Delirium in a child with new focal neurology, seizures, or a sudden drop in GCS demands urgent neuroimaging — the delirium may be the presenting sign of a CNS lesion, encephalitis, or raised intracranial pressure
• Never reach for an antipsychotic before you have identified and treated reversible causes — infection, hypoxia, metabolic derangement, pain, withdrawal, and drug effects
• A positive CAPD screen in a child on escalating benzodiazepines is a red flag for iatrogenic delirium — review the sedation plan, not just the behaviour

Life stages

Care settings

Clinical exam formats

Board mappings

• General and Community Paediatrics
• Mental and behavioural health
• Acute clinical care and the critically ill child
• Current 2026 PREP curriculum — Learning goal 5: Clinical assessment – essential general paediatrics
• Current 2026 PREP curriculum — Learning goal 11: Recognise and manage the acutely ill child
• Renewed curriculum for first-year trainees from 2027 — Learning goal 5: Clinical assessment
• Critical care and mental-health competencies
• Clinical Applications
• Acute and critical care
• Long Cases
• Short Cases
• Communication scenarios
• 1. Working with children and young people: Acute presentations
• 4. Professional skills and knowledge: Patient management
• Level 2: Assesses and manages the acutely ill child including mental-health and neurological status
• Foundation of Practice (FOP)
• Applied Knowledge in Practice (AKP)
• Acute neurology and critical care
• Clinical
• History
• Communication
• Child in PICU / acute neurological assessment
• General Pediatrics Content Outline — Domain 6: Critical Care
• General Pediatrics Content Outline — Domain 10: Neurology
• General Pediatrics Content Outline — Domain 15: Mental and Behavioral Health
• General Pediatrics EPA: Recognise and manage acute neurological dysfunction
• Patient Care 1: History and Physical Examination
• Patient Care 4: Clinical Reasoning
• Medical Knowledge 1: Clinical Knowledge
• Systems-Based Practice: screening and care bundles in the PICU
• Medical Expert
• Collaborator
• Pediatrics: Core EPA — Managing the acutely ill child
• Pediatrics: Core EPA — Recognising acute neurological dysfunction