The document provides tips for effectively communicating with confused patients in the emergency department (ED). It notes that patients may have barriers like word finding difficulties, reduced understanding, sensory issues, or reverting to their first language. The ED itself can also be confusing due barriers like noise, lights, activity levels, and unfamiliar faces. Some recommendations include speaking slowly, using simple sentences and repetition, being specific, offering choices, using visual cues, stating intentions, providing context, and keeping the patient oriented. Effective communication is important to help confused patients feel at ease in the fast-paced ED environment.