• Emerg. Med. Clin. North Am. · Feb 2024

    Review

    Hyperactive Delirium with Severe Agitation.

    • Brian Springer.
    • Division of Tactical Emergency Medicine, Department of Emergency Medicine, Wright State University, 2555 University Boulevard, Suite 110, Fairborn, OH 45324, USA. Electronic address: brian.springer@wright.edu.
    • Emerg. Med. Clin. North Am. 2024 Feb 1; 42 (1): 415241-52.

    AbstractHyperactive delirium with severe agitation is a clinical syndrome of altered mental status, psychomotor agitation, and a hyperadrenergic state. The underlying pathophysiology is variable and often results from sympathomimetic abuse, psychiatric disease, sedative-hypnotic withdrawal, and metabolic derangement. Patients can go from a combative state to periarrest with little warning. Safety of the patient and of the medical providers is paramount and the emergency department should be prepared to manage these patients with adequate staffing, restraints, and pharmacologic sedatives. Treatment with benzodiazepines, antipsychotics, or ketamine is recommended, followed by airway protection, supportive measures, and cooling of hyperthermia.Copyright © 2023 Elsevier Inc. All rights reserved.

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