Acute Confusion and 'Off Legs' course for GPs



Common in older people, delirium, also known as acute confusional state and 'off legs' have subtle features, leading to under-diagnosis. A result of several causes, they may lead to serious long term problems. Early recognition and management is therefore vital.
This session was reviewed by Khyati Bakhai and last updated in September 2020.
Learning Objectives
By the end of this session you will be able to:
- Describe the importance of delirium (acute confusion)
- Identify delirium at an early stage
- Institute management strategies for delirium
- Explain the common causes of 'off legs'
- Provide initial assessment and management of 'off legs'
Delirium is often under-diagnosed, resulting in suboptimal management. Slow diagnosis can also prolong the course of delirium and cause further comorbidity.
Shane O’Hanlon is a Consultant in Elderly Care at the Royal Berkshire Hospital, Reading. He works in surgical liaison and with the Macmillan COCOC (Comprehensive Care for Older People with Cancer) team. He works closely with primary care teams in this role and has a passion for medical education.

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