Recommended
More Related Content
Recently uploaded
Recently uploaded (6)
Featured
Featured (20)
Delirium in ICU severity score system and management
- 3. Delirium • outcome • Risk factor • Detection score • Management • prevent
- 5. 評 估 方 法 • 加 護 病 房 混 亂 評 估 方 法 (The Confusion Assessment Method for Intensive Care Units, CAM-ICU) • 加護病房譫妄檢查表 (Intensive Care Delirium Screening Checklist, ICDSC) 是最有效可靠的加護病房譫妄評估 工具。 • Grade (A)
- 6. 中文版 CAM-ICU • 中文版為莊、林和許等人（2007）所翻譯並測試，共31位受試者，其中有28 位經2位專科護理師同時診斷出譫妄，其評估者間一致性 Kappa值為 .48（p <.01）。 • Lin等國內學者（2004）針對國內69歲以上使用呼吸器老人研究中，訓 練研究助理運用中文版CAM-ICU為譫妄評估工具，與資深精神科醫師 以DSM-IV為譫妄評估標準做比較，結果敏感度分別達90％以上，特異 性達98％。 • • 建議三：患者住院 24 小時內進行第一次評估，爾後每日評估一次（C， level VI）。 成大急重症加護病房譫妄臨床照護指引 97/12/10
- 7. CAM-ICU
- 9. CAM-ICU and RASS • 評估時需先使用Richmond Agitation-Sedation Scale (RASS) • 做躁動－鎮靜評估， • 以避免因鎮靜劑造成意識不清影響CAM-ICU判別之正確性 • 當RASS 評分介於－3到＋4，才能使用CAM-ICU做譫妄評估 (Ely et al., 2001a; Lin et al., 2004; McNicoll et al., 2005) 。 成大急重症加護病房譫妄臨床照護指引 97/12/10
- 10. RASS
- 11. CAM-ICU delirium screening in critically ill patients: a systematic review and meta- analysis
- 12. ICDSC
- 16. 預防 Delirium
- 18. Most use in delirium
- 19. Thank you
- 21. CAM-ICU
Editor's Notes
- 1. We recommend performing early mobilization of adult ICU patients whenever feasible to reduce the incidence and duration of delirium (+1B). We provide no recommendation for using a com-bined nonpharmacologic and pharmacologic delirium prevention protocol in adult ICU patients, as this has not been shown to reduce the incidence of delirium in these patients (0,C) 2. We do not suggest that either haloperidol or atypi- cal antipsychotics be administered to prevent delir- ium in adult ICU patients (–2C). v. We provide no recommendation for the use of dex- medetomidine to prevent delirium in adult ICU patients, as there is no compelling evidence regard- ing its effectiveness in these patients (0,C).