You know what? F**k it, add a rectal swab. Labs - Now we're talking: complete blood count, chemistries ( chloride is crucial here, more so than creatinine or liver function tests), troponin (come on, you've ordered troponins for less), blood glucose, TSH, RPR, B12.Neurologic exam - Same as physical exam.Physical exam - Exam also never useful.Sundowning is a subtype of altered mental status where gomers and gomeres go batsh*t crazy the second the sun sets. You name it: disturbance in attention, fluctuating attention, memory deficit, disorientation, agitation, confusion, throwing poop, ripping out PICCs and Foleys, and making known to all their impressive vocabulary of curse words.
#Altered mental status differential professional#
In sum, when you have a patient with altered mental status, just document "multifactorial" as the cause and you'll be all set.Īs for the health care professional population, the most common causes of altered mental status are hanger pains, uremia from not urinating all month, and cirrhosis from too many liver rounds. This page includes the following topics and synonyms: Altered Level of Consciousness Causes, Altered Mental Status Differential Diagnosis, ALOC Causes. What it did not capture was seizures, because EEGs never capture seizures. Ha! What doesn't cause altered mental status? What we will say is that in the 1940s, electroencephalograms (EEGs) helped document that altered mental status was the result of global cortical dysfunction. In fact, the risk of altered mental status increases with age, length of stay, number of comorbidities, number of medications, and number of alien bodies introduced ( central line, arterial line, Foley catheter, etc.). An overview of the causes and evaluation of states of acutely altered mental status, including delirium, somnolence, agitation, and psychosis. Nearly 100% of patients over than the age of 65 have experienced altered mental status in any of its glorious forms.
It all falls under the umbrella term of altered mental status.
Delirium, confusion, agitated, sleepy, lethargic, doesn't matter. Altered mental status is possibly the most common presenting complaint for patients in the emergency room, especially gomers.
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