Altered mental status classification: Difference between revisions
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![[Delirium|Delirious]] | ![[Delirium|Delirious]] | ||
|Disoriented; restlessness, hallucinations, sometimes delusions | |Disoriented; restlessness, hallucinations, sometimes delusions | ||
|Some scales have "delirious" below this level, in which a person may be restless or agitated and exhibit a marked deficit in [[attention]]. | |Some scales have "delirious" below this level, in which a person may be restless or agitated and exhibit a marked deficit in [[attention]]. | ||
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![[Lethargic]] | ![[Lethargic]] | ||
Revision as of 18:55, 27 February 2014
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Altered mental status Microchapters |
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Diagnosis |
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Treatment |
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Altered mental status On the Web |
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American Roentgen Ray Society Images of Altered mental status |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Pratik Bahekar, MBBS [2]
Overview
Classification
Scales and terms to classify the levels of consciousness differ, but in general, reduction in response to stimuli indicates an altered level of consciousness:
| Level | Summary | Description |
|---|---|---|
| Conscious | Normal | Assessment of LOC involves checking orientation: people who are able promptly and spontaneously to state their name, location, and the date or time are said to be oriented to self, place, and time, or "oriented X3".[1] A normal sleep stage from which a person is easily awakened is also considered a normal level of consciousness. "Clouding of consciousness" is a term for a mild alteration of consciousness with alterations in attention and wakefulness. |
| Hyperalert | Increased arousal and hypersensitivity | Heightened arousal with hypersensitivity to immediate surroundings. Verbally and physically threatening, restless, aggressive[2] |
| Confusion | Disoriented; impaired thinking and responses | People who do not respond quickly with information about their name, location, and the time are considered "obtuse" or "confused".[1] A confused person may be bewildered, disoriented, and have difficulty following instructions. The person may have slow thinking and possible memory time loss. This could be caused by sleep deprivation, malnutrition, allergies, environmental pollution, drugs (prescription and nonprescription), and infection. |
| Delirious | Disoriented; restlessness, hallucinations, sometimes delusions | Some scales have "delirious" below this level, in which a person may be restless or agitated and exhibit a marked deficit in attention. |
| Lethargic | Reduced activity | Reduced alertness with minimum interest in the surrounding.[3] |
| Somnolent | Sleepy | A somnolent person shows excessive drowsiness and responds to stimuli only with incoherent mumbles or disorganized movements.[1] |
| Obtunded | Decreased alertness; slowed psychomotor responses | In obtundation, a person has a decreased interest in their surroundings, slowed responses, and sleepiness. |
| Stuporous | Sleep-like state (not unconscious); little/no spontaneous activity | People with an even lower level of consciousness, stupor, only respond by grimacing or drawing away from painful stimuli.[1] |
| Coma | Cannot be aroused; no response to stimuli | Comatose people do not even make this response to stimuli, have no corneal or gag reflex, and they may have no pupillary response to light.[1] |
References
- ↑ 1.0 1.1 1.2 1.3 1.4 Kruse MJ (1986). Nursing the Neurological and Neurotrauma Patient. Totowa, N.J: Rowman & Allanheld. pp. 57&ndash, 58. ISBN 0-8476-7451-7.
- ↑ "Clinical Review: Delirium in older people".
- ↑ "http://www.clinpedemergencymed.com/article/S1522-8401(08)00024-4/abstract". External link in
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