Cardiac arrest and intensive care unit (ICU) admission both cause significant physical and psychological stress. It is common for patients to become disoriented whilst being treated in the ICU and this can lead to patients becoming agitated and aggressive. This is referred to as ‘delirium’ and will normally pass with time.

A patient with delirium is hallucinating, which means they can be seeing, hearing, or feeling things that don’t exist outside their mind. They can imagine they are in different situations,
and these are often very frightening. The patient is convinced that what they are experiencing in their mind is actually happening. It can be terrifying for them and very worrying for relatives however, the presence of loved ones can help to reorientate patients experiencing delirium.

What is it like to have delirium?

Patients with delirium can find it very difficult to understand or remember information – so even if they appear to understand what is happening, or maybe join in a conversation, they may not remember what has just been said to them. Delirium can also change quickly, one minute you will be having a normal conversation and next they will say something that makes no sense to those listening.

A person with delirium may:

  • Be less aware of what is going on around them
  • Be unsure of who they are or where they are
  • Be unable to have a meaningful conversation
  • Have poor attention, concentration and memory
  • Hear or see things which are not there
  • Worry that others are trying to harm them
  • Be very agitated or restless
  • Be very slow or sleepy
  • Have moods which change very quickly

What causes delirium?

There are many causes of delirium, including:

  • Too much or too little oxygen
  • Urine and chest infections
  • Side effects of medicines e.g. pain killers, steroids
  • Major surgery
  • Alcohol
  • Suddenly stopping drugs
  • Pain
  • Dehydration
  • Constipation
  • Being in an unfamiliar place
  • Terminal illness

It is more common in people who:

  • Are over 65 years old
  • Have memory problems, poor eyesight or hearing
  • Have recently had surgery
  • Have a severe illness 

How can I help someone with delirium?

  • Stay calm, listen and offer reassurance
  • Use simple sentences, check that they have understood you and repeat things if necessary
  • Make sure that someone they know well is with them
  • Help them to eat and drink
  • Remind them of where they are and the time and date. If possible make sure they can see a clock or calendar
  • Ensure they have their glasses and hearing aid/s
  • Bring in some familiar objects from home
  • Have a light on at night so they can see where they are

More Information

ICU Step Information Sheet

ICU Delirium (US)

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