Delirium in children

Delirium in children is a special form of impaired consciousness - its deep clouding with hallucinations, incoherent speech, motor agitation.

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Causes of delirium in children

The most probable causes of delirium syndrome in children may be poisoning with drugs, overheating, toxicomania, acute infections. In adolescents, delirium is possible after the use of antidepressants, neuroleptics or anticholinergics, as well as alcoholism.

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Symptoms of delirium in children

Delirium in children is characterized by inhibition, disorientation, illusory perception of the situation, catching "snowflakes" and "little animals". At the onset of delirium, increasing anxiety, a feeling of fear, especially in the evening, sweating, facial flushing, tachycardia, hypotension, fine tremor and general weakness are noted. Then, a narrowing of the volume of thinking and clouding of consciousness are noted, changing over time. Disorientation, illusory perception of the situation and the surrounding world are exacerbated in the evening and at night, optical and tactile hallucinations begin. Decompensation of vegetative functions and blood circulation is possible.

Diagnosis of delirium in children

Characteristic anamnesis, behavioral and conscious disturbances, especially at night. Presence of optical and tactile hallucinations. Mydriasis. Ataxia.

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Emergency medical care for delirium in children

If the patient is not dangerous to himself or others, diazepam or lorazepam, or chlordiazepoxide are administered. If the patient is agitated, if there are no contraindications, haloperidol is recommended (contraindicated in poisoning). Glucose and thiamine should be administered intravenously. When deep sleep occurs, it is necessary to maintain airway patency and eliminate possible circulatory disorders. In case of arterial hypotension, rheopolyglucin, prednisolone are administered intravenously by drip with the addition of phenylephrine (mesaton) or dopamine in severe cases. Heart rhythm disorders are relieved: verapamil is prescribed for supraventricular tachycardia, lidocaine is prescribed for ventricular tachycardia and threatened ventricular extrasystoles. The use of folic acid, barbiturates and magnesium sulfate is indicated.

If the cause of delirium is drug poisoning, the stomach is washed with water through a tube, activated carbon is administered, then a saline laxative (sodium or magnesium sulfate) is used, and a cleansing enema is done. Oxygen therapy with 50% O ₂ is necessary. To remove toxic substances from the body, hemodilution is first provided: 0.9% sodium chloride solution, 5-10% glucose solution, disol, and then furosemide (lasix) are administered intravenously by drip for 10 minutes.

If somatic problems prevail, the patient is hospitalized in the intensive care unit; if the general condition is stable, he or she is hospitalized in the psychiatric department (after examination by a psychiatrist from the ambulance team).

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