Delirium in intensive care is linked to longer stays, more deaths and lasting cognitive problems. Prevention rests on routine, unglamorous measures: daily screening with a validated tool, the lightest sedation that is safe, avoiding benzodiazepines where possible, early mobilisation, and protecting sleep.
Glasses and hearing aids, a visible clock, natural light by day, darkness and quiet at night, and family presence all help with orientation. Check for and treat pain, urinary retention, constipation and drug causes before reaching for an antipsychotic.
- Screen for delirium every shift with a validated tool such as CAM-ICU or ICDSC
- Use the lightest safe sedation and avoid benzodiazepines where possible
- Return glasses and hearing aids, and protect night-time sleep
- Mobilise early and encourage family presence
- Look for pain, retention, constipation and drug causes first
Why it matters
The basics are where most of the preventable delirium burden lies.
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