Drug Induced Delirium

kfortune@bmcf.com

Does anyone have an example of a drug induced delirium query that they wouldn't mind sharing?  I have several charts where the physician documented confusion due to pain medication.

afrady@hcpro.com

Take it for what it is worth (just my opinion).  When you have a medication with a known psychoactive element which directly or even indirectly alters brain chemistry and or causes neurological manifestations such as being "intoxicated", "high", "relaxed", "sleepy" etc. and the patient becomes confused BEYOND what was expected and or "delirious", I usually avoid encephalopathy and consider this to be the correct use of the "drug induced delirium" reporting.    

In general, pain medications are supposed to relieve pain.  They are not meant to create confusion, nor do we always expected confusion in these patients..... which should make this reportable. 

It would however, need to be documented beyond just "mildly confused", "pleasantly confused" etc...as being a little "buzzed" WOULD be expected in many patients and would not be separately reportable.

If the patient is hallucinating, getting violent, has no idea where they are, disconnects from reality and thinks it is a different circumstance or even time I their life,  standing in the bed doing a strip tease, running off, attacking other patients etc. (what we in my old unit referred to as "Friday night")...you are good with that reporting.

lostwater

Alan, indeed, delirium may be appropriate, but delirium is a manifestation of something else... hence I would be sincerely looking at the cause as some form of encpehalopathy.

afrady@hcpro.com

lostwater said:

Alan, indeed, delirium may be appropriate, but delirium is a manifestation of something else... hence I would be sincerely looking at the cause as some form of encpehalopathy.

That's a good point.   My post above is assuming you have already eliminated all other possible causes of metabolic disruption and end up not having found found any link.