Delirium

Delirium in children is a special form of consciousness disturbance - its deep obscuration with hallucinations, incoherent speech, motor excitement.

[1], [2], [3], [4], [5], [6], [7], [8]

Causes of delirium in children

The most likely causes of delirious syndrome in children can be poisoning with drugs, overheating, substance abuse, acute infections. In adolescents delirium is possible after the use of antidepressants, antipsychotics or anticholinergics, as well as alcoholism.

[9], [10], [11], [12], [13], [14], [15], [16]

Symptoms of delirium in children

Delirium in children is characterized by inhibition, disorientation, illusory perception of the situation, catching "snowflakes", "small animals." At the beginning of the development, delirium is marked by growing anxiety, a sense of fear, especially in the evening, sweating, flushing of the face, tachycardia, hypotension, small-scale tremor and general weakness. Then they note the narrowing of the volume of thinking and the obscuration of consciousness, which changes with 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

A characteristic anamnesis, impaired behavior and consciousness, especially at night. Presence of optical and tactile hallucinations. Middrias. Ataxia.

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Emergency medical treatment for delirium in children

If the patient is not dangerous to themselves and others, inject diazepam or lorazepam, or chlordiazepoxide. When the patient is excited, if there are no contraindications, recommend haloperidol (contraindicated in case of poisoning). You need to inject glucose and thiamine intravenously. At the onset of deep sleep, maintenance of airway patency and elimination of possible circulatory disorders are required. With arterial hypotension intravenously drip reopoliglyukin, prednisolone with the connection in severe cases of microfluid injection of phenylephrine (mezatonum) or dopamine. They stop heart rhythm disturbances: supraventricular tachycardia is prescribed verapamil, with ventricular tachycardia and threatened ventricular extrasystoles - lidocaine. The use of folic acid, barbiturates and magnesium sulfate is shown.

If the cause of delirium development is poisoning with medicines, the stomach is washed with water through a probe, activated charcoal is injected, then a saline laxative (sodium or magnesium sulfate) is applied, and a cleansing enema is made. Oxygen therapy is required 50% O ₂. To remove toxic substances from the body first provide hemodilution: intravenous drip for 10 minutes, enter 0.9% sodium chloride solution, 5-10% glucose solution, disul, and then furosemide (lasix).

With the prevalence of somatic problems, the patient is hospitalized in the ICU, in the case of a stable general condition - in the psychiatric ward (after an examination by the psychiatrist of the ambulance team).

[22], [23], [24], [25],