DIMSO

Question 1

D in DIMS

Answer 1

Consider all drugs

1. Too much or too little of a medication
2. Polypharmacy
3. Street drugs Hx
4. Urine toxicology (salicylates, amphetamines, cocaine)

Withdrawal

1. Alcohol/Benzodiazepines
2. Barbiturates

Question 2

I in DIMS

Answer 2

Look for invisible and visible infections

1. Visual inspection of skin
2. Urine dipstick - UTI
3. Blood culture - SIRS
4. CXR - pneumonia
5. Query LP - meningitis

Question 3

M in DIMSO

Answer 3

Metabolic hypers or hypos
1. Extended lytes: sodium, potassium, 
2. Glucose
3. TSH
4. PTH
5.

Question 4

S in DIMSO

Answer 4

Structural changes to brain

1. Trauma
2. Vascular damage
3. Tumor
4. Seizure
5. Parkinson’s

Question 5

O in DIMSO

Answer 5

Organ systems at risk

1. GFR and creatinine - Kidney
2. LFT - Liver
3. ECG and Troponins - Heart
4. CBC - Anemia

Question 6

What is the acronym for delirium and LOC?

Answer 6

DIMS-o
Drugs/withdrawal
Infections
Metabolic
Structural
Organ systems