ALOC Flashcards
def ALOC
altered level of consciousness
change in a pt’s state of awareness (ability to relate to self and the environment) and arousal (alertness)
what does lethargic, obtunded and stupor mean?
lethargic: severe drowsiness, can be aroused by mod stimuli
obtunded: similar to lethargic, slowed responses to stimulation
stupor: only vigorous and repeated stimuli will arouse the pt
*clinically, they’re all kind of used interchangable
def coma
state of unarousable responsiveness
what are the types of altered mental status? (3)
- delirium
- dementia
- psychosis
what are the main causes of ALOC? tip: AEIOU-TIPS
A = Alcohol, Acidosis
E = Epilepsy, Endocrine, Electrolytes, Environment, Encephalopathy
I = Insulin (i.e. hypo- or hyper-glycemia)
O = Overdose, Oxygen deprivation
U = Underdose, Uremia
T = Trauma, Tumor, Toxin, Temperature
I = Infection
P = Psychiatric, Poison
S = Stroke, Sepsis, Shock, Seizure
tell me the grading of eyes in GCS
4 - Spontaneous
3 - Loud voice
2 - To pain
1 - None
tell me the grading of verbal response in GCS
5 - Oriented
4 - Confused
3 - Inappropriate words
2 - Incomprehensible sounds
1 - No sounds
tell me the grading of motor response in GCS
6 - Follows commands
5 - Localizes to pain
4 - Withdraws to pain
3 - Abnormal flexion - decorticate
2 - Abnormal extension posturing - decerebrate
1 - None
when should we intubate for GCS?
<8
what is mild, moderate and severe on the GCS scale?
mild: 13-15
moderate: 9-12
severe: 3-8
what are some important hx questions?
collateral history
- last seen normal
- hx trauma
- hx of illnesses/pre-existing conditions
- hx of mental illness
- current medications
- gradual vs abrupt
- preceding symptoms
- environmental factors
- drug or alcohol use
- acute on chronic condition?
how does the DIMES mnemonic work for ALOC?
D – Drugs
I – Infections
M – Metabolic
E – Environmental
S – Structural
how to tx ALOC?
tx underlying cause
DONT forget ➔ coma cocktail
- Dextrose
- O2
- Naloxone
- Thiamine
