Context

Delirium is among the most common of medical emergencies. Prevalence is around 20% in adult acute general medical patients, and higher in particular clinical groups, such as patients in intensive care units. It affects up to 50% of those who have hip fracture and up to 75% in intensive care [1].

Patients with delirium have:

• Increased length of hospital stay
• Higher risk of complications in both medical and surgical settings
• Higher mortality, both in hospital and up to 6 months following discharge [2]
• High risk of developing dementia in future [3]

Preventative measures can reduce the incidence of delirium [1]. It is an essential skill for emergency physicians to be able to identify, rationally assess and implement effective initial treatment strategies in confused elderly patients.