Altered Mental Status
Resources to Review Prior to Conference
Goals and Objectives
Goals
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Trainee will demonstrate competence in the initial evaluation and basic management of patients with altered mental status
Objectives
Trainee will be able to:
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Define and describe the differences between delirium, dementia and psychosis
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Outline steps in the initial assessment to the patient with altered mental status
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Produce a differential diagnosis for altered mental status
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List rapidly reversible causes of altered mental status and appropriate interventions for each diagnosis
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Alcohol withdrawal –> GABA agonists
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Hypoglycemia –> Dextrose
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Hypoxia –> Supplemental oxygen
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Hypercarbia –> Ventilation
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Hyper/hypothermia –> Cooling/warming measures
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Hypertensive encephalopathy –> Antihypertensives
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Opioid intoxication –> Naloxone
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Describe common exam findings and diagnostic studies used to determine the etiology of altered mental status
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Describe basic treatments for each disease category included in the differential diagnosis of altered mental status
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List and describe non-pharmacologic and pharmacologic strategies to treat patients at risk of harming themselves or others
Additional Resources
Overview
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AMS (CDEM 2019)
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AMS (First 10 EM 2018)
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AMS Part 1 (EM:RAP 2016)
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AMS Part 2 (EM:RAP 2016)
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Alcohol Withdrawal
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Alcohol Withdrawal (emDocs 2016)
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Hypertensive Encephalopathy
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Hypertensive Encephalopathy (EM:RAP 2020)
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Opioid intoxication
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Psychiatric Disease
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Psychiatric Patients (ACEP Clinical Policy 2017) (pdf)