A hospital can be a scary place for any of us, but the experience is likely to be especially upsetting for children. An unfamiliar environment, possibly painful procedures, immobility, food that’s not from home (or no food), and disturbed sleep are hard on most people. A child’s particularly vivid imagination may exacerbate an already-frightening experience. It’s not surprising that delirium can occur in hospitalized children.

Characteristics of pediatric delirium.

Delirium in children has not been explored to the extent that it has been in adults, but research suggests its manifestations in either group can include five characteristics: agitation, disorientation, hallucinations, inattention, and sleep–wake cycle disturbances. Some evidence also suggests that children with delirium may have a more labile affect than adults, and more severe perceptual disturbances.

A systematic review of current evidence.

In this month’s AJN, Cheryl Holly and colleagues share the results of their descriptive epidemiological study to explore delirium in children. Their findings can help us to recognize the problem earlier and understand more about measures that may prevent it. As the authors note:

“The early recognition and management of pediatric delirium may help
prevent unwarranted laboratory testing and imaging studies, which can
cause children and families unnecessary distress.”  

Learn more about risk factors, characteristics, and nursing implications in this month’s original research article and CE feature, “Recognizing Delirium in Hospitalized Children:  A Systematic Review of the Evidence on Risk Factors and Characteristics.” 

Image credit: Doyle Alphabet by fdecomite, via Flickr.