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Alasdair MacLullich
@A_MacLullich
Transforming delirium care. Physician & Professor @EdinburghUni. New family guide book on delirium - coming 2026 - the4at.com/family-deliriu…
Edinburgh, Scotland
research.ed.ac.uk/en/persons/ala…
Joined December 2013
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    Alasdair MacLullich
    @A_MacLullich
    May 12
    ⚠️ 3 days until the first CMS Age-Friendly Hospital Measure attestation (May 15). Domain 3 requires validated screening for cognitive impairment AND delirium in patients 65+. ✅ The 4AT covers both. ~2 mins. No training. Free. the4AT.com #delirium #patientsafety
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    Alasdair MacLullich
    @A_MacLullich
    Jul 4, 2020
    SIGN Guidelines on #Delirium = one of the few recent comprehensive guidelines in the field. The best evidence + expert consensus on clinical care. Valuable tips for practitioners. Full guideline - free to download: sign.ac.uk/assets/sign157…
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    Alasdair MacLullich
    @A_MacLullich
    Sep 18, 2020
    #Delirium treatment is complex. ✔️ Here is DELIRIUM 8 - a set of 8 key domains to consider when looking after a person with delirium.
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    Alasdair MacLullich
    @A_MacLullich
    Nov 21, 2022
    With respect, that's my clinical work & some frail older people have good pain control with that kind of analgesia. We start most at 2-3mg qds oxycodone & adjust as needed. Some start at 1mg qds oxycodone. The key is frequent assessments to balance pain & toxicity risk.
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    Chief Cat Herder 💙
    @Cat_Herder_Boss
    Nov 21, 2022
    Replying to @A_MacLullich and @clare_eliza
    Mate, if you had a hip fracture I guarantee you’d be begging for more than 2.5mg of Oramorph
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    Alasdair MacLullich
    @A_MacLullich
    Mar 26, 2025
    #Delirium is not just altered behaviour. It is a manifestation of acute encephalopathy - measurable with EEG changes & altered biomarkers.
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    Alasdair MacLullich
    @A_MacLullich
    May 21, 2025
    Delirium treatment should involve *brain care* AND *mind care* - the latter is often missing, or done inadequately.
    32K
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    Alasdair MacLullich
    @A_MacLullich
    May 7, 2021
    🏥 It's important to assess for both #frailty & #delirium at the front door. 📕 Study: Clinical Frailty Scale (CFS) & 4AT have complementary value in predicting hospital admission in older #ED patients 🔗 sciencedirect.com/science/articl… #CFS #4AT
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    Alasdair MacLullich
    @A_MacLullich
    Jan 27, 2025
    Delirium management is much more than 'treat the cause'. Article: "Humanizing delirium care" A really useful concise guide. Open access. A lot of this is about engaging & communicating with each patient as an individual so that you can address their fears effectively.
    21K
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    Alasdair MacLullich
    @A_MacLullich
    Jun 5, 2020
    There are many causes of distress in people with #delirium. ➧ Distress can lead to agitation. ➧ Agitation can lead to often inappropriate drug Rx. Always ask: ⚡ WHY is this person distressed / agitated? ⚡
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    Alasdair MacLullich
    @A_MacLullich
    Nov 12, 2020
    ✨New #delirium review in Nature Reviews Disease Primers. Up to date and comprehensive.✨ PrimeView - a quick summary - below. 🧠Review: nature.com/articles/s4157…🧠 @DiseasePrimers @emmavardy2 @dhj_davis @delirious_dr @DrLizSampson @deliriumkrish @NydahlPeter @andyteodorczuk
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    Alasdair MacLullich
    @A_MacLullich
    Dec 29, 2022
    🧠 #Haloperidol is commonly used as a 'treatment' for #delirium ❓ Yet the only recommended use is for severe distress/safety concerns ➡️ New ICU study: haloperidol ineffective in improving mortality/discharge/other outcomes 🔗 pubmed.ncbi.nlm.nih.gov/36286254/ @WesElyMD
    55K
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    Alasdair MacLullich
    @A_MacLullich
    Jun 2, 2020
    Sudden withdrawing of antidepressants & many other drugs can cause #delirium. Think twice before scoring off drugs - sometimes no change or tapering down is more appropriate. ncbi.nlm.nih.gov/pubmed/31896883
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    Alasdair MacLullich
    @A_MacLullich
    Jan 10, 2023
    ❓ Can #delirium be managed safely at home? ➡️ Crucial issue given the growth of community-based care as an alternative to hospital admission ⭐ New pilot study on feasibility of new approach - appears safe & effective 🔗 Open access: rcpjournals.org/content/future… @emmavardy2
    40K
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    Alasdair MacLullich
    @A_MacLullich
    Jul 3, 2020
    Older people in hospital are vulnerable. This study looked at rates of: #delirium, falls, functional decline, new incontinence. These complications strongly associated with with poor outcomes. ncbi.nlm.nih.gov/pubmed/30423197