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