Altered Mental Status Flashcards

1
Q

Assessment for Altered Mental Status

A
  • ABC’s
  • 100% O2 and assist ventilation prn r/t pt condition
  • IV Access
  • Respiratory effort
  • GCS (intubation if =8)
  • Pupils
  • Gag reflex (intubation if absent)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Possible Etiology

A
  • Suspected or known head injury or increased ICP: intracranial bleed/mass or metabolic
  • Suspected or known toxic ingestion, hypoglycemia, seizures
  • Sepsis
  • Shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Suspected or known head injury or increased ICP

A
  • Watch for signs of herniation: unilateral dilated unresponsive pupil, bradycardia, HTN, Cheyne-Stokes/agonal respirations.
  • Contact medical control
  • Consider TBI protocol in known trauma.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Suspected or Known Toxic Ingestion/Hypoglycemia, SZ

A
-Correct hypoglycemia if <70 mg/dl:
Infant: D10W 5 mL/kg IV
Child: D25W 2mL/kg IV
Adolescent: D50W 1mL/kg IV
-*Narcan (if toxic ingestion):
<20 kg: 0.1 mg/kg IV
>20 kg: 2 mg, may repeat if pt responds
*May give Flumazenil if benzodiazepine OD suspected: 0.01 mg/kg (max single dose 0.2 mg), May repeat up to 0.05 mg/kg or 1 mg, whichever is lower. (Max total dose 3 mg in one hour)
*Do not use Flumazenil in pt w/ known SZ disorder or chronic benzodiazepine use.
-SZ; Ativan 0.1 mg/kg IV (Max 4 mg)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Signs of Sepsis

A
  • Fever
  • Leukocytosis
  • May be hypothermic and/or neutropenic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Signs of Shock and Tx

A
  • Delayed cap refil
  • Tachycardia
  • Decreased perfusion
  • 20 mL/kg NS, proceed to shock protocol
How well did you know this?
1
Not at all
2
3
4
5
Perfectly