Summary

Key Points

• Causes of delirium span a broad range and can be multifactorial
• When delirium is present, clinicians should look for an underlying cause(s)
• History and physical exam are guided by knowledge of the differential diagnosis for delirium
• A thorough history including medications and collateral information is key
• Physical exam should be thorough
  • looking for signs of occult infection or trauma
  • incorporating assessment of cognition and alertness
• Testing can be guided by history and physical exam, but most patients will warrant some basic lab and/or imaging testing
• The ADEPT tool can provide evidence-based guidance for work-up and management of delirium in the acute care setting