Delirium Assessment in Critically Ill Children

Delirium is defined as an acute change in consciousness accompanied by inattention and the inability to receive, process, recall, or store information.¹  There are 3 forms of delirium, and patients may exhibit any combination of the forms. The hyperactive subtype of delirium may be recognized by older names (eg, intensive care unit [ICU] psychosis, ICU syndrome, and delirium). Patients with this form of delirium exhibit behaviors such as agitation, restlessness, emotional lability, hallucinations, and/or pulling at invasive catheters or tubing. These patients are thought of as at risk for self-harm or extubation, so are closely monitored and given medication to decrease their symptoms. Patients with hypoactive delirium can demonstrate flat affect, withdrawal, apathy, inattention, lethargy, and/or decreased responsiveness. These symptoms may not trigger cause for concern as patients are assumed to be thinking clearly. This failure to recognize delirium may lead to a lack of monitoring or treatment despite...