Altered mental status resident survival guide

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

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Treatment

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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.