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Delirium referral hospital — DGM MCQ

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EasyDeliriumDelirium referral hospitalDGM

A 90-year-old woman is in a care home and develops acute confusion, drowsiness and reduced oral intake over 12 hours. She has a respiratory rate of 26/min and new oxygen saturation of 88%. She normally walks with a frame and chats with staff. Current medicines include amlodipine and donepezil. What is the most appropriate referral?

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Correct answer: D — Urgent hospital assessment

Acute delirium with hypoxia and physiological deterioration requires urgent hospital assessment. Memory, optician and falls referrals do not address acute illness, and known dementia should not prevent escalation when clinically appropriate. Delirium may be the first sign of serious infection or hypoxia in older people.

Reference: NICE CG103; NICE sepsis guidance