Altered Mental Status
A. Alcohol
E. Endocrine(thyroid), Electrolyte(Na,Ca), Epilepsy, Encephalopathy
I. Insulin ( hyper-/hypoGlycemia)
O. Oxygen, Opioid
U. Uremia
T. Trauma, Temperature
I. Infection (CNS, Systemic)
P. Poison, Psychosis
S. Shock(HypoVolemic, AMI), Stroke/SAH/Structural lesion
Hx: 什麼候開始, 怎麼不一樣(baseline如何), Seizure/Epilepsy, Headache/ head injury, Drug (new drugs)
PE: TPR, BP, SpO2, Auscultation, Tongue-biting, Head trauma, Odor(EtOH, Ketone)
NE: Pupil(pinpoint/dilate, deviation), GCS, Babinski
Lab: FingerSugar, BUN/Cr, Na/Ca, LFTs/NH3, CBC-DC/PLT, PT/aPTT, BloodCulture, UA/U.culture, Toxic Screen, Alcohol, BZD, TFTs, Troponin
Exam: EKG, CXR, (Brain + C-spine) CT, Lumbar puncture