Geriatric Quick Consult       Delirium       Don't #2

Don't sedate patients before evaluation

Too often, a busy physician will receive a phone call from a distressed nurse regarding a patient's disruptive behavior and will order medication to control the behavior without first evaluating the cause. This usually leads to an undesirable cascade of events and poor outcomes.

Knowledge Action
Commonly, agitated and disruptive behaviors are the result of delirium.

There's a stepwise evaluation that is recommended when this sort of behavior occurs (see "DO's") and these should be undertaken before simply sedating the patient.

Prescribing sedation empirically may interfere with proper evaluation of the real cause of the altered behavior.

Obviously these cautions do not apply if the behavior problem is ongoing and has previously been properly evaluated.
  • Before sedating disruptive patients, evaluate for delirium.
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