Delirium and Agitation

ABCs
  • Ensure staff + patient safety
  • Maintain personal space
  • If violent → call for help immediately
  • Check vitals + RBS
  • Treat reversible causes:
    • Hypoglycemia
    • Hypoxia
    • Pain
    • Dehydration
    • Urinary retention
  • De-escalation (FIRST LINE)
    • Calm, non-threatening approach
    • Do not argue
    • Validate feelings, reassure
    • Offer simple choices
    • Reduce stimuli (noise, light)
    • Consider family/sitter if appropriate
Differential (DIMS-RAT)
  • Delirium / Dementia / Depression
  • Infection (UTI, sepsis, meningitis)
  • Metabolic (glucose, Na, CO₂, thyroid, liver)
  • Structural (stroke, seizure, tumor)
  • Retention (urine/stool)
  • Alcohol / Drugs
  • Toxins / Medications
HPI & examination
  • Collateral from staff/family
  • Reason for admission / prolonged stay
  • Previous agitation episodes
  • Risk factors
    • CVA, dementia, psychiatric illness
    • Alcohol use/withdrawal
    • Sensory impairment
  • Review
    • Medications (new/missed)
    • Infection or metabolic triggers
Management
  • Non-Pharmacologic (Always First)
    • Reorientation + reassurance
    • Optimize environment
    • Close observation
  • Investigations (If Indicated)
    • CBC, U&E
    • VBG
    • Urinalysis
    • Septic workup if febrile
    • CT brain if trauma / focal signs
  • Escalation
    • Persistent aggression or danger → call for help
    • Failure of de-escalation + medications
    • Suspected delirium (infection/metabolic)
    • Consider Psychiatry/Geriatrics consult
    • ICU if severe withdrawal or unstable
  • Pharmacological
ScenarioCluesManagement
General agitation/deliriumUnsafe behavior, no specific causeHaloperidol 0.5–1 mg PO/IV/IM
Check ECG for QTc before
Repeat q30 min if needed (max 5 mg/day)
Avoid in Parkinson’s / Lewy body
Alcohol withdrawal (mild–moderate)CIWA <8–15Thiamine 100 mg IV BEFORE glucose
Diazepam 5 mg OR Lorazepam 2 mg IV
Alcohol withdrawal (moderate–severe)CIWA >8Thiamine 100 mg IV BEFORE glucose
Diazepam 5–10 mg OR Lorazepam 2–4 mg
Severe withdrawal/delirium tremensCIWA >20 or poor responseThiamine 100 mg IV BEFORE glucose
Escalate → ICU
Elderly/frailHigh sensitivityUse lower doses (e.g., Diazepam 2 mg / Lorazepam 0.5 mg)
Start low, go slow

Studying for R1? The IM Rapid Review covers this in the same format — see the sample chapter.

Last reviewed · May 2026

MOC