Altered Mental Status Lecture Review

A set of vocabulary flashcards covering the definition, treatment protocols, and the AEIOU-TIPS mnemonic for assessing patients with altered mental status.

Altered Mental Status

A sudden or gradual change in level of responsiveness or awareness, which can range from being unconscious or lethargic to displaying bizarre behavior, belligerence, or self-mutilation.

XCAB

The sequence used in treatment to maintain stability; it includes positioning the airway appropriately and providing rescue breathing if the patient is unconscious.

AEIOU-TIPS

A mnemonic used for detective work to identify causes of altered mental status: Alcohol, Epilepsy/Electricity, Insulin, Overdose, Uremia, Trauma, Infection, Psychiatric, and Stroke/Shock.

Alcohol (in AEIOU-TIPS)

A potential cause of AMS where the provider must gather history and note surroundings without assuming it is the cause every time.

Epilepsy/Electricity (in AEIOU-TIPS)

A potential cause of AMS where the provider checks history, looks at medications, checks for incontinence, and uses a cardiac monitor.

Insulin (in AEIOU-TIPS)

A cause of AMS involving diabetes where the provider checks for insulin scars on the abdomen or thigh and determines the blood sugar level.

Overdose (in AEIOU-TIPS)

A cause of AMS where the provider looks for pills, asks witnesses about recent surgery, and checks for constricted pupils (indicating narcotics) and respiratory rate.

Uremia (in AEIOU-TIPS)

A cause of AMS associated with renal failure history, identified by a shunt in the arm, jaundice, or dehydration.

Trauma (in AEIOU-TIPS)

A cause of AMS assessed by a head-to-toe exam, listening to lung sounds, feeling for a rigid and warm abdomen (internal bleeding), and checking for unequal pupils.

Infection (in AEIOU-TIPS)

A cause of AMS characterized by high or very low temperature and potential sources like diabetic or decubitus ulcers, often seen in nursing home or cancer patients.

Psychiatric (in AEIOU-TIPS)

A cause of AMS often involving noncompliance to medications; unlike other causes that present with sedation, these patients often present with too much energy.

Stroke/Shock (in AEIOU-TIPS)

A cause of AMS assessed via the Cincinnati exam, history of strokes, blood pressure, pulse, and $O_2$ sat.

Cincinnati exam

A specific assessment tool used to evaluate a patient for signs of a stroke when they present with altered mental status.

Spice Mania

A specific event mentioned in the transcript involving two people seizing in a tent in a homeless camp that initiated a public health PSA.

Decubitus ulcer

A bed sore or pressure ulcer that should be checked for as a potential source of infection causing altered mental status.

Constricted pupils

A physical sign during an AMS assessment that specifically indicates the presence of narcotics.