Recognition and management of paediatric delirium in a children's hospital setting

Abstract

Background: Delirium is a severe neuropsychiatric syndrome of rapid onset, precipitated by multiple aetiologies (Jones et al., 1992; Traube et al., 2014). Delirium is associated with significant morbidity with a mortality rate as high as 26% but can be difficult to identify in children (Hatherill, 2010). There is limited literature on the recognition and management of delirium in children. National guidelines have been amended to include hospital-wide management of acute mental state and general wards require clear pathways of identification and management of delirium. Objectives: This session aims to: • provide an updated review of the available literature on recognition and management of delirium in hospitalized children; • identify screening tools and management pathways used in paediatric hospitals; and • develop guidelines for the assessment and management of delirium in the Queensland Children's Hospital. Methods: A narrative review approach is used to examine the literature produced in the last 10 years on recognition of paediatric delirium in hospital settings, the tools used to screen for delirium and management pathways accessed by hospital staff. Findings: • Outside of the paediatric intensive care unit, the local state-wide Queensland Children's Hospital did not yet have a hospital-wide protocol for recognizing and managing children with delirium. • There are numerous assessment tools and no local consensus as to which assessment tools should be prioritized in the case of suspected delirium. Conclusions: An assessment and management pathway is proposed. Increasing the early recognition of delirium and having a clear pathway for managing delirium in a hospital setting will be useful in preventing unnecessary investigations, prolonged patient and staff anxiety, and hospital costs.L6276975442019-05-21 <br />