Your SlideShare is downloading. ×
0
Icu psychosis
Icu psychosis
Icu psychosis
Icu psychosis
Icu psychosis
Icu psychosis
Icu psychosis
Icu psychosis
Icu psychosis
Icu psychosis
Icu psychosis
Icu psychosis
Icu psychosis
Icu psychosis
Icu psychosis
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Icu psychosis

2,017

Published on

Published in: Health & Medicine
0 Comments
3 Likes
Statistics
Notes
  • Be the first to comment

No Downloads
Views
Total Views
2,017
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
87
Comments
0
Likes
3
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide

Transcript

  • 1. ICU SYNDROME/ICUPSYCHOSISPresented byBasil Kuriakose
  • 2. INTRODUCTION Advances in medical science and technology haveprompted the establishment of many highlyspecialized units (ICUs) providing intensive patientcare. ICU psychosis /Delirium in the intensive care unit isa serious problem that has recently attracted muchattention. As the number of intensive care units and thenumber of people in them grow, ICU psychosis isperforce increasing as a problem.
  • 3. DEFINITION Eisendrath defined "ICU Syndrome" /"ICUpsychosis" as an acute organic brain syndromeinvolving impaired intellectual functioning andoccurring in patients treated within a critical careunit.
  • 4. INCIDENCE It is commonly found in the critically ill with a reportedincidence of15-80% By some estimates, 80% of elderly intensive-carepatients develop the condition, which frequently leads tonursing home stays and a hastened death.
  • 5. ETIOLOGY AND PRE DISPOSING FACTORS Sensory overload Sleep deprivation Immobilization Severe emotional stress Unfamiliar environment Dehydration Low Hemoglobin level Hypoxemia Pain Infection Drugs Prolonged stay in ICU and advancing age
  • 6. CLINICAL MANIFESTATIONSSudden onset of impairment in cognition Disorganized thinking Difficulty in concentrating Problems with orientation in time and/or placeand/or person Altered affect, often with emotional liability Altered perception of external stimuli Impairment of memory Changes in sleep–wake cycle Hallucinations Agitation or change in activity levels
  • 7. DIAGNOSTIC EVALUATION Confusion Assessment Method Mini mental status examination Explore other organic causes
  • 8. MANAGEMENT The management strategy is to“wait and watch”.Non Drug Management Continuity of health care personal Clear concise communication Repeated verbal reminders of time, place andperson. Clock, calendar, TV, newspaper, radio readilyaccessible as a means of orientating in time
  • 9.  Simplify the environment, single room whenavailable, reduce noise levels, remove unnecessaryequipment Adjust lighting according to day and night cycle. Keep familiar objects Flexible visiting hours Allow maximum periods of uninterrupted sleep Encourage mobilisation and increase activity levels Relaxation techniques like music therapy andmassage may also help.
  • 10. PHARMACOLOGICAL MANAGEMENT Antipsychotic agents such as haloperidol iscommonly used. Olanzapine and respiridone have been used asthey are less sedating and have fewer side effects Benzodiazepine would be beneficial, andlorazepam is the drug of choice.
  • 11. OTHER THERAPEUTIC MEASURES Adequate pain management Avoid offending drugs Correct fluid and electrolytes Treat infection Administer oxygen Correct hypoglycemia Treat underlying cardiac problems
  • 12. ASSIGNMENT Do a concealed observation of your ICU and find outthings and factors that can be avoided to preventICU syndrome also suggest some measures toprevent ICU syndrome. Formulate a scale to assess ICU syndrome
  • 13. REFERENCES Lewis, Heitkemper, Dirksen O’Brien, Bucher. MedicalSurgical Nursing. Seventh edition. Nodia: Elsevierpublication; 2007.p no-1576-78,1736-37. Mark Borthwick. Richard Bourne. Mark Craig. AnnetteEgan. Prevention and Treatment of Delirium in CriticallyIll Patients. United Kingdom Clinical PharmacyAssociation. June. 2006. Granberg. Malmros. Bergbom. Lundberg. Intensive CareUnit Syndrome/Delirium Is Associated With Anemia,Drug Therapy And Duration Of Ventilation Treatment.Acta Anaesthesiol Scand 2002; 46: 726–731 Sandeep Jauhar .When A Stay in Intensive CareUnhinges the Mind. The New York Times. December 8,1998. Richard C. Monks. Intensive Care Unit Psychosis.Canadian Family Physician. Vol. 30: February 1984, PNo- 383-389

×