Delirium isn’t a harmless observation — it’s a red flag of serious underlying pathology. And although encephalopathy may underlie it, naming the process isn’t enough. Treat delirium as a syndrome that demands the question: What prompted this and what can we do about it? Use 4AT. Use structured frameworks. Document thoroughly. Protect patients and your practice.

Let’s stop calling it “confusion.” Let’s start recognizing it as what it might be — delirium — and manage it accordingly. Our patients deserve nothing less.

Dr. Sonja Foo is a board-certified emergency medicine critical care physician completing her Neurocritical Care Fellowship at the Massachusetts General Hospital, Brigham and Women’s Hospital, and Harvard Medical School Training Program.

References

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