Altered mental status resident survival guide: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
Shown below is an algorithm summarizing the diagnosis of altered mental status according to the the | Shown below is an algorithm summarizing the diagnosis of altered mental status according to the the American Academy of Neurology guidelines.<ref name="urlwww.loyolamedicine.org">{{cite web |url=https://www.loyolamedicine.org/sites/default/files/gme/internal-medicine/continuum_2011_altered_mental_status.pdf |title=www.loyolamedicine.org |format= |work= |accessdate=}}</ref><ref name="pmid21250221">{{cite journal |vauthors=Walker HK, Hall WD, Hurst JW, Tindall SC |title= |journal= |volume= |issue= |pages= |date= |pmid=21250221 |doi= |url=}}</ref> | ||
{{Family tree/start}} | {{Family tree/start}} | ||
{{Family tree | | | | A01 | | | |A01= Patient with amnesia | {{Family tree | | | | A01 | | | |A01= Patient with amnesia | ||
Revision as of 20:29, 12 August 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Moises Romo, M.D.
Overview
Life threatening causes of altered mental status include malignant hypertension, myocardial infarction, rabies and sepsis. Other common causes of altered mental status include alcohol withdrawal, dehydration, electrolyte disturbance and hypoglycemia.
Causes
Life Threatening Causes
Life-threatening causes include conditions that may result in death or permanent disability within 24 hours if left untreated
- Carbon monoxide toxicity
- Heat stroke
- Hypothermia
- Malignant hypertension
- Myocardial infarction
- Rabies
- Sepsis
Common Causes
- Alcohol withdrawal
- Drug withdrawal
- Dehydration
- Electrolyte disturbance
- Encephalitis
- Epileptic seizures
- Hyperglycemia
- Hypoglycemia
- Meningitis
- Sepsis
Diagnosis
Shown below is an algorithm summarizing the diagnosis of altered mental status according to the the American Academy of Neurology guidelines.[1][2]
| Patient with amnesia (Amnesia, confusion, loss of alertness, disorientation, disruption of judgement, behavior and perception) | |||||||||||||||||||||||||||||
| {{{ D01 }}} | Evaluate ABCDEF • Airway • Breathing • Circulation • Disability (Glasgow coma scale) • Exposure (Rapid head to toe revision) • Fingerstick blood glucose | {{{ D03 }}} | |||||||||||||||||||||||||||
Do's
- Perform a ABCDEF evaluation as a first step.
- If combative, use physical or chemical restrain.
- Take a non-contrasted CT scan of the head before contrasted when head trauma is suspected.
- Sodium imbalances should be slowly corrected to avoid a pontine myelinolisis or a brain herniation.
Don'ts
- Do not administere glucose before thiamine, when Wernicke encephalopathy is suspected.