Altered Mental Status

Question 1

Narcan Code dose

Answer 1

2 mg

Question 2

Narcan modertae OD dose

Answer 2

0.4mg increments in non-“coding” patients

Question 3

GCS verbal

Answer 3

1- None
2- Incomprehensible
3- Inappropriate words
4- Confused speech
5- Oriented

Question 4

What is the appropriate administration of glucose for

hypoglycemia in neonates and kids?

Answer 4

Rule of 50

D10 in infants (5cc/kg)
D25 in kids (2cc/kg)
D50 in teens/adults (1cc/kg)

Question 5

What are common toxic causes of hypoglycemia?

Answer 5

Ethanol
insulin/hypoglycemics (NOT metformin)
beta  blockers 
salicylates
quinine

Question 6

What is the approach to treatment

of hypernatremia

Answer 6

Correction rate 1-2 mEq/hr

Calculate Free Water Deficit and replace with normal saline until euvolemic

Question 7

What is the approach to correction

of hyponatremia?

Answer 7

correction rate 0.5 mEq/hr or 10-20 mEq/day

If asymptomatic and Na >120- no emergent treatment

If Na <120 and +neuro symptoms, give 100cc over 10m of 3% NaCl (, additional 100cc over 50m)

Question 8

Naloxone dose

Answer 8

0.04-0.4 mg IV

Repeat dosing or increase dose to 2 mg if the initial response is inadequate.