I recently read the article “Monitoring Delirium in Critically Ill Patients: Using the Confusion Assessment Method for the Intensive Care Unit” (April 2003:25–36). I found the article interesting and educational, but I was left with several questions. In the past year, the intensive care unit (ICU) I have been working in introduced a new pain/sedation protocol for patients receiving mechanical ventilation. This protocol includes management options for pain, sedation, delirium, and sleep deprivation. Most of the nurses I work with, as well as myself, tend to use the sedation and pain management branches of the protocol the most. The article in the April issue has made me wonder if we may be potentiating the problem of delirium by using benzodiazapines more than we should.

I have a few questions about the patient example. On day 2, the patient was found to be positive for hyperactive delirium and was given lorazepam....

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