The video series Making Sense of the Confusion is designed to educate health professionals about delirium – a condition that's common, often missed, and important to manage well. These videos are designed mainly for medical students and junior doctors, but we hope they provide value for all health professionals. Created by Nisitha Ratnayake and Thomas Skerlj.

Whether you're a nurse, physio, OT, or just someone interested in Delirium, you'll find practical tips here on how to recognise it, prevent it, and manage it effectively. Each video is quick, easy to follow, and based on real-world clinical experience.

We hope these resources help you feel more confident looking after patients with delirium and spotting it before it causes harm.

Video 1 : Start

This video provides an introduction to the clinical scenario and some clinical thoughts that may be relevant. This will help you develop your clinical reasoning and prepare for the unpredictability of a ward call. Let’s jump in!

Video 2

This video is a phone call with a nurse, outlining the history and some essential clinical details. We’ll focus on the most relevant information to guide your initial thoughts and approach in managing the case.

Video 3

This video outlines risk factors, precipitating factors and some learning tips for junior doctors to remember common causes of Delirium. As we move forward, we'll also gather more details about the patient's vitals and relevant history to better understand the situation and guide our approach.

Video 4

This is a two-part video.

In Part 1, we follow the junior doctor’s initial discussion with a nurse at the nursing station. This scene highlights the sometimes difficult balance of obtaining necessary clinical information, managing non-clinical stressors and highlighting the importance of recognising this with empathetic and direct communication.

In Part 2, we delve into the collateral history the junior doctor uncovers and how it helps guide more personalised care for Mr. Anderson. We also highlight the value of closing the communication loop and involving the family in the care plan

Video 5 

This is another two-part video. In Part 1, we meet the patient Mr. Anderson. We focus on the importance of orientation, how to take a history of the confused patient, and performing an examination to help form a differential list.

In Part 2, we explore the next steps in the care plan, including how allied health staff can assist. We also look at ways to address modifiable factors and the PINCH ME mnemonic as a helpful tool for junior doctors.

Video 6 

This video highlights the role of antipsychotics and the importance of avoiding except in specific clinical circumstances. We explore alternative approaches to help reduce responsive behaviours, focusing on safer and more person-centred strategies.

Video 7 

In video 7, we hear a phone call to our junior doctor reporting that Mr. Anderson is becoming increasingly agitated and escalating.

Video 8 

Video 8 focuses on what you can do as an RMO on ward call in this situation. We highlight the importance of calling for help, recognising you’re not alone, and share practical strategies to help de-escalate safely and effectively.

Video 9 

This video focuses on a discussion between a junior doctor and a pharmacist. This is set the day prior to the ward-call scene and provides an example of how junior doctors can proactively identify at risk patients and initiate preventative strategies for these vulnerable patients. The scenario consider de-prescribing and medication optimisation, and exploration of safer alternatives to help reduce the risk of delirium.

Video 10

In this video we discuss the 4AT tool, the key components and how to utilise it appropriately. We’ll walk through three different cases, exploring how the 4AT can be effectively applied in each to assess for delirium. Let’s get started!

Video 11

In our final video, we’ll focus on common clinical issues junior doctors face in managing delirium. We’ll highlight the importance of personalised care, safe prescribing principles, and maintaining diagnostic curiosity. Along the way, we hope you’ll pick up some valuable pearls and avoid common pitfalls. Thank you for watching and Let’s dive in!