Delirium is a medical emergency which demands attention to identify underlying precipitating cause(s). CONFFUSED is a mnemonic that can be helpful to identify precipitating causes:
Central nervous system insults (e.g., stroke, seizure, concussion, trauma, subdural hematoma, intracranial bleed)
Organ insufficiency and ischemia (e.g., cardiac, pulmonary, renal, hepatic, hypertensive encephalopathy)
Nutritional deficiencies (e.g., thiamine, folate, B12, niacin deficiencies)
Fluid and electrolyte abnormalities (e.g., dehydration, hypo/hypernatremia, hypercapnia)
Fever and infection (e.g., meningitis, encephalitis, pneumonia, UTI, sepsis)
Urinary and GI tract disorders (urinary infection or retention, severe obstipation*, fecal impaction)
Sensory difficulties (e.g., pain, agitation from tethers [such as restraints], deprivation caused by isolation or absence of hearing aids or glasses)
Endocrine (increased or decreased function of the adrenal, thyroid, parathyroid, or pancreatic glands)
Drugs and drug withdrawal (e.g., anticholinergics, anticonvulsants, corticosteroids, psychotropics, alcohol, and withdrawal from alcohol, sedatives, or barbiturates).
*Obstipation is a severe form of constipation, where a person cannot pass stool or gas.