Checklist for Evaluation of New-Onset Delirium in the ICU


Initial assessment 
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Vital signs, neuro exam 
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STAT fingerstick glucose 
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Review medication list 
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Review recent events/procedures 


Labs: consider depending on context* 
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Electrolytes including Ca/Mg/Phos 
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CBC with differential 
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ABG/VBG only if hypercapneic encephalopathy likely 
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TSH 
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LFTs, ammonia 
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Relevant drug levels (e.g. lithium, digoxin, lidocaine) 
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Carboxyhemoglobin level for new presentation in winter 
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Additional tox/infectious workup as appropriate 


Consider CT head especially if* 
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Anticoagulated 
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Trauma 
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Acute/severe headache 
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Focal abnormality on exam 
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Substantially reduced level Of consciousness 


Consider LP especially if* 
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Delirium is chief complaint on admission 
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Evidence of infection (fever, leukocytosis, nuchal rigidity) 


Consider EEG especially if* 
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History of seizure 
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Exam concerning for nonconvuIsive status 


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