2scents -“Health,
That’s not a source, it’s not even a complete sentence!
You can just copy paste a few words without the context, this does not warrant a response. You fail to respond with any logic or sources to your claims, you put in so much time and effort in your foolish posts, yet whenever asked for a follow up logic to back your claims, your response is that you will do it for money.. Not even funny anymore.”
OK Fool. Here’s the whole protocol:
Btw, I didn’t charge you any money!
But I want to know is every Hatzolah guy as incompetent as you?!?
Maybe you’re the best they have to offer?!?
From W-EM:
“Altered Mental Status
Background
Alteration of arousal or content of consciousness or both
Both cerebral cortices or brainstem must be affected
Delirium vs dementia vs psych
Must quickly determine if coma is from diffuse or focal impairment
Peds
Most common causes are toxic ingestion, infection, and child-abuse induced trauma
Clinical Features
Depends on cause
Diffuse brain dysfunction – lack of focal findings
Focal brain dysfunction – hemiparesis, loss of motor tone, loss of ocular reflexes
Differential Diagnosis
Altered mental status
Diffuse brain dysfunction
Encephalopathies
Hypoxic encephalopathy
Acute toxic-metabolic encephalopathy (Delirium)
Hypoglycemia
Hyperosmolar state (e.g., hyperglycemia)
Electrolyte Abnormalities (hypernatremia or hyponatremia, hypercalcemia)
Organ system failure
Hepatic Encephalopathy
Uremia/Renal Failure
Endocrine (Addison’s disease, hypothyroidism)
Hypoxia
CO2 narcosis
Hypertensive Encephalopathy
Toxins
Drug reactions (NMS)
Environmental causes
Hypothermia
Hyperthermia
Deficiency state
Wernicke encephalopathy
Sepsis
Primary CNS disease or trauma
Direct CNS trauma
Diffuse axonal injury
Subdural/epidural hematoma
Vascular disease
Intraparenchymal hemorrhage
SAH
Infarction
Hemispheric, brainstem
CNS infections
Encephalitis
Anti-NMDA receptor encephalitis
Neoplasms
Seizures
Nonconvulsive status epilepticus
Postictal state
Psychiatric
Acute psychosis
Malingering
Diagnosis
AMS Workup
Point of care glucose
CBC
Chemistry
LFTs
UA
CXR
Utox
EKG
Head CT
?Blood and urine cultures
?Ammonia level
?Tylenol/Aspirin level
?LP
?Serum Osm
?Coags
?Cortisol
?ABG/VBG
Treatment
Patients with focal findings may have surgically treatable cause
Coma cocktail
Glucose, thiamine, naloxone
Treat underlying cause
Disposition
Most frequently admission, unless of a chronic and known etiology
See Also
Toxicology (Main)
Glasgow Coma Scale (GCS)
Altered Mental Status (AMS) (Peds)
AVPU Scale
Brain Death
References
This page was last modified 19:09, 16 December 2015″