A screen that was never done
Educational use only. Not clinically reviewed79-year-old man for calm chart reading, screening, result recording, escalation, and handoff practice. About 7 simulated minutes.
What you will practise
- Distinguish an impression from a screening result.
- Recognize that performing the screen is what changed.
- Record the result as a screening result.
- Escalate on a positive screen, not on a worry.
- Review the boundaries and their certainty.
- Hand off a record with a specific gap.
Review and sources
Not clinically reviewed. No clinician has signed this scenario.
- Shenkin SD, Fox C, Godfrey M, et al. Delirium detection in older acute medical inpatients: a multicentre prospective comparative diagnostic test accuracy study of the 4AT and the confusion assessment method. BMC Med. 2019;17:138. doi:10.1186/s12916-019-1367-9. 4AT sensitivity 76% (95% CI 61-87) and specificity 94% (92-97); CAM sensitivity 40% (26-57) and specificity 100% (98-100) under routine conditions.
- Krewulak KD, Stelfox HT, Leigh JP, et al. Scoping review of delirium motor subtype prevalence. Hypoactive delirium 50.3% (95% CI 46.0-54.7), mixed 27.7%, hyperactive 22.7%.
- Peritogiannis V, Bolosi M, Lixouriotis C, Rizos DV. Recent Insights on Prevalence and Corelations of Hypoactive Delirium. Behav Neurol. 2015;2015:416792. Hypoactive delirium is substantially under-recognised and is frequently misread as depression or fatigue.
Open Sim Lab is an educational simulator, not for clinical use. It is not a clinical decision-support tool, not a dosing calculator, and is not validated for any decision affecting a real patient.