Diagnosis and Management of Acute Mental Status Changes: Delirium

Sudden confusion can be lethal—and often missed. In this activity, you’ll diagnose with CAM and a RASS‑first ICU workflow, recognize delirium vs dementia, and treat reversible causes with a lean workup, then prevent it using practical, nonpharmacologic bundles. Manage agitation safely—avoid routine antipsychotics; use low‑dose haloperidol with QT checks—and address alcohol‑withdrawal delirium using AUDIT‑C/CIWA‑Ar to improve outcomes.

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Availability

On-Demand

Expires on Jan 22, 2029

Cost

Member: $0.00

Non-Member: $95.00

Credit Offered

2 CME Credits

2 ABIM-MOC Points

2 Participation Credits

Overview
Faculty
Accreditation
Recommended

Learning Objectives
After completing this activity, learners should be able to:

Diagnose delirium and characterize the sub-types.
Describe the morbidity and mortality associated with delirium, identify the incidence and prevalence of delirium in the inpatient setting, and explain the reasons for the high non-detection rates.
List the predisposing and precipitating risk factors for developing delirium and discuss prevention strategies in the high-risk patient.
Appreciate delirium as a medical urgency and describe an approach to the evaluation of delirium.
Discuss nonpharmacologic and pharmacologic treatment strategies for delirium.
Describe a management strategy for the prevention and treatment of alcohol withdrawal delirium.

If you are a Program Director and would like to grant access to your trainees, please reach out to education@hospitalmedicine.org for an academic access code.

Faculty

Elizabeth A. Cerceo, MD, FACP, FHM
Kurt Pfeifer, MD, FACP, SFHM, DFPM
Leonard Feldman, MD, FACP, FAAP, MHM

Faculty Disclosures
The faculty and planners of these activities have no relevant relationships to disclose. All relevant relationships were mitigated prior to the start of this activity.

Conflict of Interest Disclosure Policy
In accordance with the ACCME Standards for Commercial Support, SHM requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any commercial interest. SHM mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all its educational programs. All relevant financial relationships shall be disclosed to participants prior to the start of the activity.

Furthermore, SHM seeks to verify that all scientific research referred to, reported, or used in a continuing medical education (CME) activity conforms to the generally accepted standards of experimental design, data collection, and analysis. SHM is committed to providing its learners with high-quality CME activities that promote improvements in healthcare and not those of a commercial interest.

Accreditation Statement
The Society of Hospital Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

CME Credit Statement
The Society of Hospital Medicine designates this enduring material for a maximum of 2.00 AMA PRA Category 1 Credit(s)^TM. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

MOC Credit Statement
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 2.00 MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

SHM Consults: Perioperative and Consultative Medicine

As hospitalist roles surge, mastering consultative and perioperative care has become a career essential. Gain the proven frameworks and clinical confidence to navigate complex surgical co-management and specialist consultations, leading to safer patients and smoother workflows.

Multiple Credits

$0.00 - $599.00

Managing Pain in Postoperative Patients: What the Hospitalist Needs to Know

Sharper recoveries start at the bedside. In this case-rich activity, assess pain precisely across ages and cognition, identify mechanisms, and implement multimodal plans: acetaminophen/NSAIDs, regional techniques, and targeted adjuvants to limit opioids. Titrate and rotate using equianalgesic principles, avoid meperidine and long-acting agents, set PCA lockouts without basal in opioid-naive, and monitor outcomes to curb delirium and elevate satisfaction.

Multiple Credits

$0.00 - $95.00

SHM Consults Core Curriculum

Hospitalists are the fastest growing portion of the physician work force. Some estimate there will be 50,000 hospitalists needed in the next 10 years. As the number of hospitalists grows, so too will the clinical settings in which we practice. Consultative medicine is a service provided by many hospitalists, and a future in which almost all surgical patients are co-managed by hospitalists is already a reality for some. For many of us, our training in consultative medicine during residency was limited. We hope this curriculum will help you to feel more confident about your knowledge and skills and will lead to better patient outcomes. We welcome your comments and suggestions for future topics.

Multiple Credits

$0.00 - $399.00

Perioperative Cardiac Risk Assessment

Scrubbed in and facing a ticking clock—can your team triage cardiac risk with confidence? Translate the 2024 ACC/AHA stepwise algorithm into swift, guideline‑true moves as you identify red flags, assess functional capacity, quantify risk with RCRI/NSQIP, integrate modifiers and biomarkers, and reserve tests that change care. Walk away with a clear playbook that keeps cases safe, conversations honest, and schedules intact.

Multiple Credits

$0.00 - $95.00

Unstable Tachyarrhythmias for the Hospitalist

Many hospitalists provide critical care services without adequate support or training, putting patients at risk and exposing hospitalists to medical liability. This educational series covers common or high-risk clinical scenarios that hospitalists encounter in and out of the intensive care unit.

Multiple Credits

$0.00 - $95.00

Perioperative Geriatric Management

It is well established that older adults undergoing major surgery are at higher risk for complications and poor outcomes. This is related to a combination of decline in organ function, increased comorbidities, presence of geriatric syndromes, and reduced ability to compensate for stress. Despite overall worse outcomes, a higher proportion of people over 65 years of age are undergoing elective procedures as the population ages. It is imperative for hospitalists to be familiar with evidence-based approaches to assessment and optimization of the geriatric patient prior to surgery as well as best practices for care in the postoperative period. The American Geriatrics Society & American College of Surgeons have collaborated to create comprehensive perioperative practice standards for older adults that can be succinctly organized into a ‘Four M’ approach to ‘Age-Friendly’ care. This module reviews core principles of such care and outlines interventions shown to improve outcomes.

Multiple Credits

$0.00 - $95.00

The Hospitalist’s Role in the Perioperative Management of Hyponatremia

Hyponatremia is the most common electrolyte abnormality that occurs in hospitalized patients, and it is recognized as a serious in-hospital complication. It is a complex electrolyte disorder that results mainly from water imbalances and dysregulation of arginine vasopressin. Hyponatremia is associated with increased morbidity and mortality among geriatric patients and patients with heart, liver, or neurologic diseases. The following educational activity discusses the pathophysiology of hyponatremia, outlines methods for differentiating the cause, and provides examples of how to manage hyponatremia in various situations commonly faced by hospitalists.

Multiple Credits

$0.00 - $95.00

Neurosurgery for the Hospitalist

Successful neurosurgery co-management requires hospitalists to be familiar with the presentations, disease processes, management, and complications of neurosurgical inpatients. The first section of this activity summarizes common inpatient neurosurgical conditions. The second section prepares the reader to recognize and act on neurosurgical emergencies. The remaining four sections of the activity cover blood pressure management in patients with subarachnoid hemorrhage, sodium abnormalities in patients with brain tumors, the use of mannitol vs. dexamethasone, and the perioperative management of anticoagulants, in addition to other topics.

Multiple Credits

$0.00 - $95.00