Well first of all "confused" doesn't mean much in its own right. Does the person have delirium? dementia? both? Some other cause of cognitive impairment/behavioural disturbance/anxiety/agitation etc
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Replying to @mancunianmedic @grepmeded and
But for argument's sake, let's assume it's Delirium . What people *mean* when they use the term "pleasantly confused" is generally hypoactive delirium (so "no trouble" even though this condition may signify serious medical diagnoses & a distressed person)
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Replying to @mancunianmedic @grepmeded and
If Dementia, then the "PC" term probably means that if they have Behavioural and Psychological Symptoms they aren't manifesting with what looks like verbal/physical "aggression", restlesslness, vocalising, "wandering" etc and so are "no trouble" (though may be terrified)
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Replying to @mancunianmedic @grepmeded and
If it's another cause (let's say a closed head injury with a worsening intracranial bleed) then "pleasantly confused" might mean their conscious level has become so depressed that they are no longer exhibiting psychomotor agitation etc
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Replying to @mancunianmedic @grepmeded and
so basically, a bit like "acopia" - it's best avoided completely as its imprecise, misleading and the confusion may be far from pleasant for the patient. A term like "hypoactive delirium" is a better bet
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Replying to @mancunianmedic @grepmeded and
Picking out hypoactive delerium for experienced clinicians in optimal conditions is one thing but for stretched staff in chaotic ED with more dramatically disturbed people... we need a lot more training (&staff)
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Replying to @Jdbartlett0703 @grepmeded and
i didnt claim it was easy or straightforward.Merely that we shouldnt use the term "pleasantly confused" - when someone asked about this. Same for "acopia" "social admission" "failed OT assessment" "no rehab potential" "off legs ? cause" "mechanical fall" and other unhelpful lingo
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Replying to @mancunianmedic @Jdbartlett0703 and
the original question was do doctors use this phrase- yes, and frequently. And no harm is done. The reality is during rapid handoffs and note writing a variety of suboptimal terms are used without intent to offend. We’re clinicians not scribes.
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Replying to @grepmeded @mancunianmedic and
I would also argue “hypoactive delirium” is much more likely to confuse a junior nursing student or medical student whereas “pleasantly confused” with some choice additional verbiage a monkey can understand.
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Replying to @grepmeded @Jdbartlett0703 and
someone studying for a degree in nursing or medicine shouldn't be unsettled by precise clinical terminology. would you say "let's not say Grade 4 Sacral Pressure Sore" in case it'was a bit much. Nope we are never going to agree on this. I give uo
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i junior trainee has thousands of things they can look up and there is only so much time in the day. You are not wrong but where I practice “pleasantly confused” outnumbers “hypoactive delirium” in the charting at least 100-1. I don’t get upset it.
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Replying to @grepmeded @mancunianmedic and
And how many of those “pleasantly confused” are not treated as urgently/aggressively as they should be?
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