Registered Nurses' Association of Ontario

Nursing Best Practice Guidelines

Causes of Delirium
Mnemonic:
I Watch Death
Presenting Symptoms
I Infections Urinary tract infection (UTI), pneumonia, encephalltis
W Withdrawl Alcohol, benzodiazepines, sedatives-hypnotics
A Acute metabolic Alcohol, benzodiazepines, sedatives-hypnotics
T Toxins, drugs Opiates, salycilates, indomethacin, lidocaine, dilantin, steroids, other drugs like digoxin, cardiac medications, anticholinergics, psychotropics
C CNS pathology Stroke, tumor, seizures, hemorrhage, infection
H Hypoxia Anemia, pulmonary/cardiac failure, hypotension
D Deficiencies Thiamine (with ETOH abuse), B12
E Endocrine Thyroid, hypo/hyperglycemia, adrenal insufficiency, hyperparathyroid
A Acute vascular Shock, hypertensive encephalopathy
T Trauma Head injury, post-operative, falls
H Heavy Metals Heavy Metals

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Reprinted with permission of the American Psychiatric Publishing, Inc., www.appi.org. Adapted from: Wise, M. G. (1986). Delirium. In R. E. Hales & S. C. Yudofsky (Eds.), American Psychiatric Press Textbook of Neuropsychiatry (pp. 89-103). Washington, D. C.: American Psychiatric Press Inc.