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. Reflexes, such as the cough and gag reflexes, are also means of judging LOC. Once the level of consciousness is determined, clinicians seek clues for the cause of any alteration. 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
- ↑ 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.