https://doi.org/10.4081/scenario.2020.450

Valutazione del delirium nell’anziano in pronto soccorso: una revisione narrativa della letteratura

Vol. 37 No. 4 (2020): SCENARIO 4 2020
Submitted: 29 January 2021
Accepted: 29 January 2021
Published: 29 January 2021
Abstract Views: 1030
PDF (Italiano): 309
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Authors

Christian Ramacciani Isermann
scenario@aniarti.it
Infermiere, Pronto soccorso ed emergenza sanitaria territoriale, Ospedale “Francesco Petruccioli”, Pitigliano (Grosseto), Azienda USL Toscana Sud Est, Italy.
Moris Rosati
Infermiere, Anestesia e Rianimazione DEA e dei Trapianti, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Katia Marzocchi
Infermiere, Manpower Group, Italia, Italy.
Lorenzo Righi
Infermiere, Centrale operativa 118 Siena-Grosseto, Azienda USL Toscana Sud Est, Italy.
Introduzione: Il delirium è un problema tutt’altro che raro in pronto soccorso (PS): in letteratura emerge che un paziente su dieci sperimenti questa sindrome. Gli strumenti di screening propri di altri setting di cura raramente sono utilizzati in PS sia per la loro complessità che per la scarsa formazione. Anche fattori ambientali caratteristici del PS, come il sovraffollamento e l’elevato flusso di lavoro, possono contribuire a un loro ridotto utilizzo. L’obiettivo di questo lavoro, pertanto, è quello di ricercare in letteratura le evidenze più aggiornate e verificare quale metodo di valutazione, adoperabile dal personale non specialistico, sia il più efficace nell’identificare precocemente il Delirium nelle persone anziane in Pronto Soccorso. Materiali e metodi: È stata effettuata una revisione della letteratura consultando le banche dati MEDLINE (interfaccia PubMed) e CINAHL nel periodo che 13/04/2019-28/04/2019, limitando la ricerca con retroattività di 5 anni, lingua inglese o italiana e disponibilità del full text. Risultati: Negli 11 studi inclusi nella revisione sono state analizzate le scale Confusion Assessment Method (CAM), le sue versioni modificate mCAM-ED, bCAM e CAM-ICU, l’Assessment Test for delirium and cognitive impairment (4AT), la Richmond Agitation and Sedation Scale (RASS) e la sua versione “Modifiedâ€. Due lavori hanno valutato strumenti diversi dalle scale: lo screening di fragilità clinica e fattori di rischio. Conclusioni: La 4AT sembra emergere come più idonea per la valutazione del delirium in pronto soccorso: ha un tempo di somministrazione pari a 2 minuti, può essere eseguita dal personale infermieristico e mostra delle buone prestazioni diagnostiche sia in presenza che in assenza di decadimento cognitivo. Sono necessari però ulteriori studi per testarne l’utilizzo in PS, anche in comparazione con altri strumenti. Parole chiave: Delirium; Scores; Pronto Soccorso.

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How to Cite

Ramacciani Isermann, C., Rosati, M., Marzocchi, K., & Righi, L. (2021). Valutazione del delirium nell’anziano in pronto soccorso: una revisione narrativa della letteratura. Scenario® - Il Nursing Nella Sopravvivenza, 37(4), 9–14. https://doi.org/10.4081/scenario.2020.450

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