Altered Mental Status

Cannot miss / life threats
Cannot miss / life threats
Differential diagnosis — checklist
0/9

Check off each diagnosis as you consider it. Tap the name for unique exam, lab/imaging clues, first-line confirmatory test, and management.

AEIOU0/5
TIPS0/4
Initial ED workup
Bedside0/5
  • Glucose first
  • Pupils, GCS, focal deficits
  • Temp
  • ECG
  • POCUS for cardiac/IVC
Labs0/6
  • CBC, BMP, LFTs, ammonia
  • VBG with lactate
  • TSH, B12 if subacute
  • UA, urine tox
  • ETOH, acetaminophen, salicylate
  • Cultures if infection
Imaging0/3
  • CT head non-contrast
  • CXR
  • LP if meningitis/encephalitis
Initial management0/4
  • ABCs, protect airway (consider intubation if GCS < 8 with concern)
  • Dextrose if hypoglycemic; thiamine 100 mg IV before glucose if malnourished
  • Naloxone if opioid suspected
  • Empiric antibiotics + acyclovir if CNS infection suspected