Delirium
What is delirium?
Delirium is a complication of the PICU admission that affects awareness of surroundings, cognitive (thinking) abilities, behaviours, and emotions. Delirium may be hyperactive (restlessness, agitation, hallucinations), hypoactive (sluggish, dazed, confused), or a combination of both.
Delirium may be managed through adjusting medication levels, and is reversible when the underlying cause (reason for hospital admission itself) has been resolved.
What to look out for in children and adolescents:
Reduced or changed awareness of surroundings such as disorientation, being more distracted than normal, or being more withdrawn than normal or less responsive to their environment.
Cognitive impairment (poor thinking skills) such as poor memory of recent events, rambling or nonsense speech if they can usually speak, trouble understanding speech, or loss of focus during play.
Changes in behaviour such as hallucinations (seeing or hearing things that aren’t there), restlessness, agitation or combative behaviour,
Emotional disturbances such as anxiety or depression, irritability, apathy, or rapid mood shifts.
Any child experiencing these symptoms should receive medical and psychological intervention. If you notice these symptoms, alert clinical staff.
PICU Liberation
PICU Liberation is a holistic care approach aimed to minimise and prevent delirium and to improve the patient’s recovery and quality of life while in hospital.
It can involve interventions such as early mobilisation (a physiotherapist assisting with movements that can be done before the patient can sit or stand, or even before they are extubated), early weaning off sedation if appropriate to do so, both medical and non-medical pain relief interventions (read more here), managing the hospital environmental factors such as unnatural lighting and sounds, and patient goals such as visiting an outside balcony if available at the hospital.
You can read a blog on PICU Liberation from our team here.
Click here to see the ‘PICU Stars’ Liberation Intervention Information sheet, by the Queensland Children’s Hospital.
Below is a video on a joint project between the Queensland University of Technology (QUT) Design Lab and the Queensland Children’s Hospital in 2021.
Video source: https://www.youtube.com/watch?v=DL0TCZoCS6M
Sources:
‘Delirium: Causes, Symptoms, Diagnosis and Treatment,’ Nationwide Children’s Hospital, https://www.nationwidechildrens.org/conditions/delirium
