Treatment of Delirium + Doctor Order Set (Sample)

Suspected Delirium


– establish baseline cognitive function, h/o dementia, depression, mania, psychosis


– identify possible causes: anticholinergics, benzos, steroids, infection, DHN, sleep deprivation, malnutrition, immobilization, metabolic derangement, decreased mobility, constraints / restraints

Laboratory Work-up

– CBC, chemistry (including LFTs)

– TFTs, B12

– Ammonia

– cortisol

– screen for infection

– consider brain imaging, LP, EEG


– reorientation, encourage family involvement

– eyeglasses / hearing aids

– order sitter, avoid restraints

– uninterrupted sleep at night; use of light/dark to preserve sleep-wake cycle

– mobility, physical / occupational therapy

– if severely agitated, started pharmacologic intervention:

1. Haloperidol 0.25-1.0 mg IM/IV, repeat q20-30m, max of 3-5mg in 24h; half loading dose and give in divided doses x 24h, then taper

2. Avoid benzos unless delirium is due to ETOH withdrawal or seizures

delirium treatment 01 delirium treatment 02Assessment_and_Rx_of_deliri


Delirium Order Set


Teaching Rounds: A Visual Aid to Teaching IM Pearls on the Wards, Chapter 73.