Assessment and Management of Delirium in Older Adults in the Emergency Department: Literature Review to Inform Development of a Novel Clinical Protocol
Open accessAbstract
Delirium occurs frequently in older patients in the emergency department (ED), is underrecognized, and has potentially serious consequences. Despite its seriousness, delirium is frequently missed by emergency providers, and patients with unrecognized delirium are often discharged from the ED. Even when it is appropriately recognized, managing delirium in older adults poses a significant challenge for ED providers. Geriatric delirium is typically caused by the interaction of multiple factors, including several that are commonly missed: pain, urinary retention, constipation, dehydration, and polypharmacy. Appropriate management includes nonpharmacological management with medication intervention reserved for emergencies. We have developed a new, comprehensive, evidence-based protocol for diagnosis/recognition, management, and disposition of geriatric delirium patients in the ED with a focus on identifying and treating commonly missed contributing causes.
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- Authors
- Rosen, T., Connors, S., Clark, S., Halpern, A., Stern, M. E., DeWald, J., Lachs, M. S., & Flomenbaum, N.
- Affiliations
- Cornell University (US)
- Venue
- Advanced Emergency Nursing Journal
- Published
- 2015-07
- Volume
- 37
- Issue
- 3
- Pages
- 183-196
- ISSN
- 1931-4485 (ISSN-L)
- PMC
- PMC4633298
- OpenAlex
- W984596996
- Cited by
- 49
- References
- 82
- Citations by year
- 2026: 2 · 2025: 6 · 2024: 3 · 2023: 4 · 2022: 3 · 2021: 8 · 2020: 6 · 2019: 5 · 2018: 7 · 2017: 3 · 2016: 2
- FWCI
- 0.57
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Advanced Emergency Nursing Journal (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (UL1TR000457)
- National Institute on Aging (K24AG022399)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Intensive Care Unit Cognitive Disorders
- Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
- Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
- Keywords
- delirium, older adults, geriatric delirium, emergency department, delirium management, delirium diagnosis, non-pharmacological treatment, polypharmacy, pain, urinary retention, constipation, dehydration, discharge disposition, clinical protocols
- MeSH terms
- Aged, Clinical Protocols, Delirium, Education, Continuing, Emergency Service, Hospital, Humans
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