First Things First

• Anxiety, pain and delirium in combination or separately are common causes of agitation in critically ill patients.
• Does the patient have any life threatening causes of agitation that require immediate attention? (see Sedative Drug Use).
• The prompt and effective treatment of pain is a vital component of each patient’s care. Acute pain in hos pitalized patients is often under appreciated and inadequately treated. The patient’s responses to pain cancause adverse physiologic effects which may impede return of normal function.
• Delirium is common and is often unrecognized.