Delirium Prevention and Treatment Pathway in a Pediatric Intensive Care Unit
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Authors
Sudyka, Ashley
Issue Date
2019-08-17
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Abstract
Delirium and its’ negative effects are quite well known in the adult population, however, there is minimal research concerning delirium’s effects and its’ treatment in the pediatric population. In the past, it has been assumed that delirium presents in a similar fashion in adults and children, but this has continued to be proven otherwise. The diagnosis of delirium in pediatric patients is routinely being missed or treated incorrectly in Pediatric Intensive Care Units (PICU) worldwide as the diagnostic screening tools that have been developed utilize criteria specific to adults, making then unreliable and unusable in pediatrics. There have been recent developments in pediatric screening tools, such as the Cornell Assessment of Pediatric Delirium (CAPD) and Richmond Agitation and Sedation Scale (RASS), which gives children a score based on their behavioral symptoms. These tools have helped to make large advances in proper diagnosis of pediatric delirium. This project aimed to utilize incidence data from these tools and develop an appropriate treatment pathway to best treat those children who have screened positive for delirium in a 26-bed Midwestern PICU. 122 individual patients met criteria to be included in the study. Only 3 ultimately screened positive for delirium with a CAPD of 9 or greater then their baseline score. Using this +9 standard, the delirium rate was 3 in 99, or about 3%. The 3 positive screens were placed on the treatment portion of the delirium pathway and only 1 of the 3 delirious patients ultimately required medication. The other two were treated and reversed using the BRAINMAPS tool.
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Creighton University
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Copyright is retained by the Author. A non-exclusive distribution right is granted to Creighton University