Vandewalle G, Gais S, Schabus M, et al. Wavelength-dependent modulation of brain responses to a working memory task by daytime light exposure. Cereb Cortex. 2007;17:2788–95. One of the biggest reasons why delirium often goes unrecognized is because there’s a history of describing it using different terms or names. Today, healthcare providers use this term very specifically. Minimize tether effects. Tethers include anything that can make it harder to move around. This includes IV and oxygen lines, urinary catheters and physical restraints. Healthcare providers will use regular “tether assessments” to minimize how these items contribute to delirium.

Delirium is an acute, fluctuating change in mental status, with inattention, disorganised thinking, and altered levels of consciousness. [1] Inouye SK, Schlesinger MJ, Lydon TJ. Delirium: a symptom of how hospital care is failing older persons and a window to improve quality of hospital care. Am J Med. 1999 May;106(5):565-73. Emergence agitation (EA) and emergence delirium (ED) are frequently encountered in children emerging from general anesthesia. The incidence of EA/ED ranges between 10–80% depending on the scale used for assessment. Emergence delirium occurs most commonly in younger children (3–7 years) and following ophthalmology and otorhinolaryngology procedures [ 1]. Emergence delirium specifically is a dissociative state in which the patient is confused and dissociated from their surroundings and usually occurs within the first 30 min of recovery from anesthesia [ 2]. Sedatives (especially benzodiazepines and dexmedetomidine) have been shown to reduce the incidence of emergence delirium; however, their use often results in delayed discharge from the post anesthesia care unit (PACU) [ 2, 3]. This phenomenon often coincides with restlessness and flailing. These actions can be self- injurious and result in disruption to tubes, lines, drains, and is quite upsetting for parents and staff. Treatment of ED involved pharmacologic agents to induce sedation, most commonly propofol, benzodiazepines, or dexmedetomidine.

Viola AU, James LM, Schlangen LJ, Dijk DJ. Blue-enriched white light in the workplace improves self-reported alertness, performance and sleep quality. Scand J Work Environ Health. 2008;34:297–306. https://journals.lww.com/ccmjournal/Fulltext/2018/09000/Clinical_Practice_Guidelines_for_the_Prevention.29.aspx Most cases of delirium resolve within days, but some do persist for weeks or months. It does depend on the individual and the disease burden. Risk factors for ICU delirium

The most frequent presentation in critical care is when patients move between the two states – from agitated, hyperactive behaviour to becoming sleepy and unresponsive. Even in hospital it can be difficult for delirium to be spotted and diagnosed. This is another reason to tell staff if you notice a change in the person you care about.NHS staff caring for patients in hospital (including critical care) and long-term residential care settings (including primary care healthcare professionals) Not all patients flag up the delirium they have experienced to their care team. Some can’t even remember it taking place. Others don’t bring it up because they are embarrassed or scared to say they have these horrible nightmares or hallucinations. Although some people recover fully, delirium can also have lasting consequences after it has been treated. These are more common in older people.

Prevalence ranges from 14% to 24% in the emergency department, 15% to 53% for postoperative patients, and 70% to 87% for intensive care patients. [19] Inouye SK. Delirium in hospitalized older patients. Clin Geriatr Med. 1998 Nov;14(4):745-64.Voepel-Lewis T, Malviya S, Tait AR. A prospective cohort study of emergence agitation in the pediatric postanesthesia care unit. Anesthesia and analgesia. 2003;96:1625–30 table of contents. Delirium usually gets better. In 6 out of 10 people (60%), the symptoms disappear within 6 days. Others may have some symptoms for longer. About 1 in 20 people (5%) may still have delirium more than a month after they first had symptoms. You'll start to feel more tired and drowsy, and have less energy. You'll probably spend more time sleeping, and as time goes on you'll slip in and out of consciousness. Not wanting to eat or drink