Delirium, carphology, floccillation.

Delirium is highly prevalent, harmful and often lethal. Missed or delayed diagnosis of delirium occurs with extreme frequency, particularly in the hypoactive variant, and worsens outcome still further. The absence of effective pharmacotherapy further exacerbates adverse outcomes. Several means to improve recognition of this condition at bedside are delineated, including two little-known but valuable signs, namely picking at the bedclothes (carphology) and at the air (floccillation).