Altered mental status diagnostic criteria
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Pratik Bahekar, MBBS [2]
Overview
Diagnostic Criteria
Assessing LOC involves determining an individual's response to external stimuli.[1] Speed and accuracy of responses to questions and reactions to stimuli such as touch and pain are noted.[1] Reflexes, such as the cough and gag reflexes, are also means of judging LOC.[1] Once the level of consciousness is determined, clinicians seek clues for the cause of any alteration.[2] Usually the first tests in the ER are pulse oximetry to determine if there is hypoxia, serum glucose levels to rule out hypoglycemia. A urine drug screen may be sent. A CT head is very important to obtain to rule out bleed. In case, meningitis is suspected, a lumbar puncture must be performed. A serum TSH is an important test to order. In select groups consider vitamin B12 levels. Checking serum ammonia is not advised.
References
- ↑ 1.0 1.1 1.2 von Koch CS, Hoff JT (2005). "Diagnosis and management of depressed states of consciousness". In Doherty GM. Current Surgical Diagnosis and Treatment. McGraw-Hill Medical. p. 863. ISBN 0-07-142315-X. Retrieved 2008-07-04.
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