title: Knowledge and practices of Thai emergency physicians regarding the care of delirious elderly patients.
abstract: BACKGROUND
  The Society for Academic Emergency Medicine (SAEM) Geriatric Emergency Medicine Task Force recommends assessment of delirium for all elderly emergency department (ED) patients. Little is known about emergency physicians' (EPs) opinions regarding care of delirious elderly patients. We sought to determine the knowledge and practice experience of members of the Thai Association for Emergency Medicine regarding the care of delirious elderly ED patients.
  
  
  METHODS
  We surveyed all Thai emergency physicians from July to September 2013 using a brief online survey as this does not include any non-trained physician working in the private/provincial/community EDs, still a significant part of the ED workforce in Thailand.
  
  
  RESULTS
  We had a response rate of 50% (239/474) of which 95% (228/239) completed the survey. Respondents largely reported that <10% of their patients experience delirium. Eighty-five percent of the respondents recognized delirium as a problem that required active intervention, and 76% of the respondents thought it was underdiagnosed in the ED. Only 24% of the respondents reported routinely screening delirium in the ED and 16% reported using a specific screening tool for delirium assessment. Forty-two percent of the respondents reported treating delirium with a long acting benzodiazepine and 29% reported using haloperidol. Forty percent of respondents thought that oversedation was the most common complication associated with drug treatment of delirium.
  
  
  CONCLUSIONS
  Basic knowledge and perceptions surrounding the recognition, diagnosis, and treatment of delirium in elderly ED patients by Thai EPs vary. Most of the Thai EPs consider delirium in the ED an emergency condition, while far fewer screen for this condition. Future research and quality improvement should determine which single screening tool is appropriate for EPs in regular practice as well as how to standardize delirium management in the ED.
authors: Emergency Department, Vajira Hospital, Faculty of Medicine, Navamindradhiraj University, Khao street, Wachira Phayaban, Dusit 10300, Bangkok, Thailand ; Emergency Department, Massachusetts General Hospital (MGH), 55 Fruit St, Boston 02114, MA, USA.
authors: Jiraporn
authors: J
authors: Sri-On
authors: Emergency Department, Massachusetts General Hospital (MGH), 55 Fruit St, Boston 02114, MA, USA.
authors: Gregory Philip
authors: GP
authors: Tirrell
authors: Emergency Department, Prince of Songklanagarind University, 15 Karnchanavanich Street, Hatyai 90110, Songkla, Thailand.
authors: Prasit
authors: P
authors: Wuthisuthimethawee
authors: Emergency Department, Massachusetts General Hospital (MGH), 55 Fruit St, Boston 02114, MA, USA.
authors: Shan Woo
authors: SW
authors: Liu
keywords: Delirium; Elderly; Emergency department; Emergency physician; Knowledge
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