Question

A 72-year-old man in an aged care facility with advanced dementia becomes acutely agitated and confused after hip fracture surgery. He is pulling out lines and attempting to climb out of bed. There is no hypoxia or hypoglycaemia, and he is in a noisy, unfamiliar ward. According to the RACGP Silver Book and delirium guidance, what is the MOST appropriate initial management approach?

Accepted Answer

Identify and treat underlying causes, optimise environment (reorientation, reduce noise, ensure sensory aids) and use low-dose antipsychotics only if non-pharmacological measures fail

Answer

Use physical restraints immediately without other measures

Answer

Give high-dose benzodiazepines as first-line

Answer

Ignore the behaviour as it will settle spontaneously

Answer

Transfer to a psychiatric unit for long-term antipsychotics

Practice question