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Presentation comparison
EmergencyCovers delirium, acute confusion, toxic-metabolic encephalopathy, and post-ictal confusion.
2 of 7 diagnoses compared
| CriteriaComparison detail | DeliriumEmergency |
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Inattention plus altered awareness/arousal are the key separators. Usually precipitated by acute illness, surgery, injury, retention, constipation, pain, or medicines.
Clinical reference — not validated decision support. Review before use.
| Substance intoxicationEmergencyNot selected |
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| Substance withdrawalEmergencyNot selected |
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| Dementia with superimposed deliriumEmergencyNot selected |
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| Wernicke encephalopathyEmergencyNot selected |
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| Hepatic encephalopathyEmergencyNot selected |
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| Why it fits | Acute change, fluctuating course, inattention | Witnessed or suspected seizure, stereotyped event, post-event confusion | Time-link to use, toxidrome clues (pupils, RR, nystagmus, tremor) | Time course, tremor, sweats, tachycardia, hypertension, anxiety, seizures | Known cognitive disorder with sudden worsening | Heavy alcohol use, malnutrition, triad of confusion/ataxia/eye signs may be incomplete | Liver disease, asterixis, GI bleed, constipation, infection |
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| What argues against | Applies to the whole presentationPrimary psychosis, dementia | ||||||
| Must-not-miss | Sepsis, hypoxia, hypoglycaemia, stroke, intracranial bleed, alcohol/benzo withdrawal, urinary retention, faecal impaction | Non-convulsive status epilepticus, head injury | Opioid respiratory depression, head injury, hyperthermia | Alcohol/benzo withdrawal seizures | |||
| Bedside question | Applies to the whole presentationInattention plus altered awareness/arousal are the key separators. Usually precipitated by acute illness, surgery, injury, retention, constipation, pain, or medicines. | ||||||
| Immediate action | Applies to the whole presentationDo vitals, BGL, sats, attention testing, collateral, and medication/substance review early Use 4AT in most adult settings, and ICU tools where appropriate | ||||||
| Investigations | Applies to the whole presentationBlood glucose, Vitals and oxygen saturation | ||||||
| Mimics / overlap | Applies to the whole presentationPrimary psychosis, dementia, severe depression, catatonia | ||||||
Scroll horizontally to review more candidate differentials. Clinical reference — not validated decision support. Review before use.
Primary psychosis, dementia
Inattention plus altered awareness/arousal are the key separators. Usually precipitated by acute illness, surgery, injury, retention, constipation, pain, or medicines.
Do vitals, BGL, sats, attention testing, collateral, and medication/substance review early Use 4AT in most adult settings, and ICU tools where appropriate
Blood glucose, Vitals and oxygen saturation
Primary psychosis, dementia, severe depression, catatonia
Acute change, fluctuating course, inattention
Sepsis, hypoxia, hypoglycaemia, stroke, intracranial bleed, alcohol/benzo withdrawal, urinary retention, faecal impaction
Witnessed or suspected seizure, stereotyped event, post-event confusion
Non-convulsive status epilepticus, head injury
Safety first. Act early.
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Last updated: Pending review
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Create a concise comparison summary for documentation or handoff.
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v10 | Local content only
Last updated: Pending review
| Infection, retention, constipation, dehydration, medication toxicity, pain |
| Permanent cognitive injury, Korsakoff syndrome |
| GI bleed, sepsis, over-sedation, impending coma |