Grilled Cheese

ExploreLog inSign up
Terms of UsePrivacy PolicyCommunity StandardsHelpGet the app

Grilled Cheese is a product of Village Compute

Version devBuilt at: 2026-10-12 04:31:30 EDT

Explore

PostsPeople
LatestRanked
@amaclullich.bsky.socialSep 23, 2026, 8:07 PM

Robert-Fleury's painting of Pinel striking the chains from asylum patients (1876) commemorates a radical idea: the confused are ill, not dangerous, and care beats restraint.

Modern delirium practice is the same argument in modern dress.

#delirium #history

Nineteenth-century painting. In the stone courtyard of an asylum a young woman in a white gown stands with her arms out while a restraint is unbuckled from her wrist. A man in a dark coat and a crowd of onlookers watch from the left. Women in ragged clothes sit and lie along the wall on the right, one being unchained on the ground, with discarded irons on the flagstones.
@amaclullich.bsky.socialSep 23, 2026, 11:26 AM

"Denies pain" means little from a patient who is unable to say where it hurts.

In dementia and delirium, pain hides as agitation or silence.

Use an observational pain tool, treat, reassess.

Painkillers before tranquillisers.

#delirium

@amaclullich.bsky.socialSep 23, 2026, 10:30 AM

Overnight confusion and agitation, clearer this morning.

The 4AT (a delirium test) includes the recent course: new restlessness and disorientation reported by night staff score 4 on item 4.

Alertness 0, questions 1, attention 1, acute change 4: 6 out of 12. Possible delirium.

#Delirium #4AT

Six-panel 4AT comic: Mr Hassan, 70, had a 4AT of 0 on admission with a chest infection. He was restless and disorientated overnight. This morning he is alert, makes one AMT4 error and skips July in months backwards. Night staff confirm the change was new. Scores 0, 1, 1, 4; total 6/12. The overnight change still counts.
@amaclullich.bsky.socialSep 23, 2026, 7:06 AM

Delirium aftercare: name it in the discharge letter, teach the early signs of recurrence, expect gradual recovery, talk about frightening memories, book cognitive follow-up.

The episode ends before the caring should.

#delirium

Card headed 'Aftercare: after delirium'. Five points: name it in the discharge letter; teach the early signs of recurrence; expect gradual recovery over weeks to months; talk about frightening memories; book a cognitive follow-up. Footnote: the episode ends before the caring should.
@macesari.bsky.socialSep 22, 2026, 5:13 PM

⚠️ Call for applications ⚠️
(please share)

#Guideline Methodologist: #WHO guideline on the prevention, diagnosis and management of #delirium in older adults, including #medication safety and #deprescribing

#Methodology #GRADE #EtD

⏰ Deadline: 7 October 2026

www.who.int/news-room/ar...

@amaclullich.bsky.socialSep 22, 2026, 3:30 PM

03:10. “Settled. Slept well.”

He was awake, watching men lower a net from the ceiling, keeping still so they would not see him.

Quiet is not asleep. Hypoactive delirium is about half of all cases and the half that gets missed.

#delirium #4AT

@amaclullich.bsky.socialSep 22, 2026, 11:42 AM

This image captures what many patients actually experience.

Delusions (false beliefs that feel completely real) affect up to 1 in 3 older hospital patients with delirium.

A gentle question that can help: "Can you tell me where you think you are right now?"

#Delirium

Piranesi, 'The Round Tower' from Carceri d'invenzione (Imaginary Prisons), about 1750. An etching of a vast, impossible prison interior: a barred cylindrical tower, staircases and gantries running in every direction, with tiny figures lost among them.
@amaclullich.bsky.socialSep 22, 2026, 10:30 AM

Before a planned hip replacement, Mrs Wilson scores 0/12 on the 4AT (a delirium test): normal alertness, correct AMT4 (age, date of birth, place, year) and months backwards, and no acute change.

This baseline gives the team a point of comparison. Repeat the 4AT after surgery.

#Delirium #4AT

4AT scoring comic: Mrs Wilson has a baseline assessment before planned hip replacement. She is alert, answers all four AMT4 questions correctly and says nine months backwards correctly. Her husband reports no change. All four items score 0; total 0/12. The closing message says to repeat the 4AT after surgery.
@amaclullich.bsky.socialSep 21, 2026, 7:29 PM

Study spotlight: 184 older surgical patients, recovery-room EEG (brain waves) (Markus et al., Anesthesiology 2026).

Those who became delirious had weaker alpha and beta brain waves; those who stayed well had stronger ones.

A lead on catching risk in recovery.

#delirium

@amaclullich.bsky.socialSep 21, 2026, 10:30 AM

Sleepy under 10 seconds on waking, then normally alert: alertness 0 on the 4AT (a delirium test).

One mistake in the AMT4 (age, date of birth, place, year) scores 1. Mrs Murray completes months backwards and has no reported acute change: total 1 out of 12. Possible cognitive impairment. #Delirium

4AT scoring comic: Mrs Murray wakes on an admission unit. Sleepiness lasts under 10 seconds, then alertness is normal. She makes one AMT4 mistake, says nine months backwards correctly, and her son reports no change. Scores: alertness 0, AMT4 1, attention 0, acute change 0. Total 1/12: possible cognitive impairment.
@amaclullich.bsky.socialSep 21, 2026, 6:58 AM

Myth: Keep #delirium patients in bed.

Fact: Encouraging mobility can greatly aid recovery from delirium.

An older man in a blue hospital gown walks with a wooden walking stick while a nurse in navy scrubs holds his forearm to steady him. Yellow-walled ward with empty beds; another patient lies in a bed behind them.
@stefanovilla.bsky.socialSep 21, 2026, 5:02 AM

il-musicista-loggionista.blogspot.com/2026/09/ivan...

#Fossati #IvanoFossati #Music #cd #Italy #Delirium

@amaclullich.bsky.socialSep 20, 2026, 4:18 PM

“The fever of my soul rendered every sight a maddening vision, and I was overtaken by a #delirium in which truth and nightmare danced as one.”

Edgar Allan Poe, The Black Cat, 1843

Dark engraving of a stone cellar. Men in Victorian coats and top hats crowd in, one holding a torch aloft, others swinging a pickaxe and a shovel at the rubble. In the broken wall recess a cat with arched back stands on the head of a corpse standing upright, its face and long hair visible. A bearded workman leans on a pick at the left.
@amaclullich.bsky.socialSep 20, 2026, 1:22 PM

To watch someone you love be restrained is to carry it long after.

Families remember that moment more vividly than anything else in the admission.

Even when necessary, it wounds.

Explain before, sit with them after, and make it truly the last resort.

#delirium

@amaclullich.bsky.socialSep 20, 2026, 10:30 AM

In the previous 4AT (a delirium test scored 0 to 12) example, Mrs Taylor scored 4/12 from the cognitive items alone.

Now she has a new change: she no longer recognises her carers.

Item 4 adds 4 points, giving 8/12: possible delirium on top of her dementia.

#Delirium

Six-panel 4AT comic: Mrs Taylor, who has severe dementia, is assessed two weeks after the previous example. She is awake but has not recognised her carers since this morning. AMT4 and months backwards are untestable. The carer says this is new. Scores: alertness 0, AMT4 2, attention 2, acute change 4. Total 8/12: possible delirium, with or without cognitive impairment.
@newgirldark.bsky.socialSep 19, 2026, 7:53 PM

When reality fractures into confusion and fear, patience can become the light that guides them near.
#DarkPoetry #Delirium #MentalHealthAwareness #Caregiving #Compassion

@amaclullich.bsky.socialSep 19, 2026, 6:02 PM

Account from a patient, anonymised.

"They come at night with needles. They whisper about you. The machines beep codes. You're not a patient - you're a subject. No one believes you."

How do you cope when you're certain the doctors are experimenting on you?

#delirium

Looking up from an operating table at four masked theatre staff in blue caps and gowns, lit from behind by the overhead lamp. The person on the right holds a syringe upright and stares down at the camera; a monitor glows in the background.
@amaclullich.bsky.socialSep 19, 2026, 11:04 AM

"He saw visions of ships sailing through the air, and heard voices calling his name."

Notes from Underground, Dostoevsky

#delirium

Book cover. Top line: "VINTAGE DOSTOEVSKY". Across the lower half: "NOTES from UNDERGROUND". Behind the type, a black arched fanlight window grid on a mottled orange and rust ground.
@amaclullich.bsky.socialSep 18, 2026, 6:17 PM

A familiar voice can settle a delirious person when no professional voice can.

Keep calls short, calm, simple.

Say who you are, that they are safe, that you are coming. No quizzing.

If video confuses, use voice alone.

#delirium

@walaszek.artSep 18, 2026, 3:08 PM

Dr. Fick shared this terrific fishbone diagram listing causes of undetected #delirium in healthcare settings.

She also noted @amaclullich.bsky.social's seminal work in delirium, including the development of 4AT. #medsky

Causes of undetected delirium in healthcare settings
Load more