2 year old altered mental status

Question 1

altered mental status mnemonic for any age

Answer 1

AEIOU-TIPS

Alcohol
Endocrine/Electrolytes/Encephalopathy/Epilepsy
Insulin
O2/Opiates/Overdose
Uremia

Trauma/Temperature
Infection/Intracranial
Poisoning/Psychosis
Seizure/Stroke/Sepsis/Shock/Space Occupying lesion

Question 2

How would you stabilize pt with tachycardia, hypotension, hypoxia, hypoglycemia

Answer 2

bolus of 20cc/kg NS for tachy/hypotension

O2

Bolus of D10 or D25

Question 3

Cholinergic toxicity sxs

Answer 3

SLUDGE

Salivation, lacrimation, urination, defecation, GI motility, emesis

also: Miosis/blurred vision, seizures, coma, muscle twitching

Question 4

anticholinergic toxicity sxs

Answer 4

blind as a bat (dilated pupils)

dry as a bone (dry skin)

red as a beet (flushed)

hot as hades (fever)

mad as a hatter (delirium/seizures)

tachycardia

urinary retention

Ileus

Question 5

sedative-hypnotic toxicity sxs

Answer 5

slow everything down:

blurred vision from miosis or mydriasis

hypotension

apnea/bradycardia

hypothermia

sedation/confusion/delirium/coma

Question 6

opioid tox sxs

Answer 6

slow everything down and pinpoint pupils:

miosis

respiratory depression

bradycardia/hypotension

hypothermia

sedation/confusion/coma

Question 7

sympathomimetics tox sxs

Answer 7

ramped up and dilated pupils:

mydriasis

fever/diaphoresis

tachycardia

agitation/seizures

Question 8

common accidental ingestion in toddlers

Answer 8

iron supplements and tylenol

Question 9

when would TCA tox have peak effects

Answer 9

7-8hours

Question 10

What to order w/ suspected toxic ingestion

Answer 10

Glucose
Electrolytes,blood gas
EKG
Calcium
Tox Screen
Acetominophen level