Management
Hypothermia
➤ The authors recommend that clinicians use the following temperature
thresholds to define the presence of hypothermia:
• Two or more temperature measurements ≤95.9°F (≤36.0°C) OR
• Two or more temperature measurements documenting a decrease in temperature of
>2°F (>1.1°C) from the resident's baseline non-illness temperature.
The authors recommend that clinicians further evaluate a resident who
meets the above definitions of hypothermia for the presence of infection,
while considering the possibility of non-infectious causes of hypothermia.
Hypotension
➤ The authors recommend that clinicians define hypotension as a systolic
blood pressure of ≤90 mmHg in an individual with a previously normal
systolic blood pressure.
The authors recommend that clinicians further evaluate a resident
who meets the definition of new-onset hypotension for the presence of
infection, while considering the possibility of non-infectious causes of
hypotension.
Hyperglycemia
➤ Individualized approach.
The authors recommend that clinicians further evaluate a resident with
new-onset hyperglycemia for infection, while considering the possibility of
non-infectious causes of hyperglycemia.
Delirium
➤ The authors recommend that clinicians use the Confusion Assessment
Method (CAM) to identify the presence of delirium in a resident of a
nursing home. CAM requires:
• The presence of acute change in mental status with fluctuating discourse AND
• Inattention; AND EITHER:
▶ Disorganized thinking ; OR
▶ Altered level of consciousness
The authors recommend that clinicians evaluate a resident who meets the
definition of delirium for the presence of infection, while considering the
possibility of non-infectious causes of delirium.
