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Terminal Delirium

Vanessa Cardy, MD and Stuart Swadron, MD, FRCPC
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Crunch Time - Palliative Care - Written Summary 170 KB - PDF

Terminal Delirium

Vanessa Cardy MD and Stuart Swadron MD

  • Goals of care
    • Remove distress
      • Sedation in actively dying patient
    • Address cause
      • But only if will relieve/not worsen distress
  • Management
    • Minimize stimulation
    • Comforting environment
    • Medications
      • Lorazepam 0.5-4mg subQ/IV/SL/PR
      • Midazolam 1-10mg q4h subQ/IV
      • Methotrimeprazine 5mg q6h subQ/IV
      • Haloperidol 0.5-1mg PO/subQ/IV/IM q1H prn
      • Phenobarbital (wide dose range depending on degree of agitation)
      • Consider sub-dissociative dose ketamine

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Palliative Care Full episode audio for MD edition 24:31 min - 34 MB - M4ACrunch Time - Palliative Care - Individual MP3 Files 26 MB - ZIPCrunch Time - Palliative Care - Written Summary 170 KB - PDF