In delirium management in the ICU, which non-pharmacological intervention has the STRONGEST evidence for prevention?
- A ABCDEF bundle (including early mobility, sleep hygiene, reorientation, hearing/vision aids) ✓
- B Prophylactic haloperidol 0.5 mg TDS for all ICU patients
- C Melatonin supplementation only
- D Benzodiazepine sedation to reduce agitation
Correct answer: A. ABCDEF bundle (including early mobility, sleep hygiene, reorientation, hearing/vision aids)
Explanation
The ABCDEF bundle (Assess/prevent/manage pain, Both SAT/SBT, Choice of sedation/analgesia, Delirium assessment, Early mobility, Family engagement) is the strongest evidence-based multicomponent non-pharmacological strategy for ICU delirium prevention. Prophylactic haloperidol has not shown benefit in trials. Benzodiazepines are a risk factor for delirium, not prevention. Melatonin alone has insufficient evidence.
Reference: Kaplan & Sadock's Synopsis of Psychiatry, 11th ed.
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