Treating an Altered Mental Status as a First Responder

[musicislife]

Doesnt say much in my book besides the many causes of it. Would I just monitor ABCs and do a physical examination of a patient who is unresponsive/ not alert an oriented. (with main focus on maintaining ABCs)?

[paramedicmike]

Some of your questions so far have been great and you've gotten some good answers. If you're going to seriously engage in this business, however, you'll need to be able to think on your own.

So, what do you think you would need to do? Why do you think you would need to do it?

[Eydawn]

ABCs as your first focus is an excellent place to start.

There are a myriad of conditions that can cause altered mental status... your job is to try to find out as much as you can about WHY the patient has altered mental status, while monitoring them until help arrives. The more info you can give the transporting medics, the better... take clues from the environment.

Let's start with totally unresponsive. For example, if the person is found near partially full or empty medication bottles, take a look to see what they are, when they were filled, etc... could be something as simple as an accidental OD on pain pills, or something as complicated as an intentional polypharmacy overdose (many different drugs with different actions). Could be a diabetic- look for identifiers, insulin pumps, glucometers in their belongings, etc... could be post-ictal after a seizure; look to see if they were incontinent, etc. Could be a full blown MI... do they have nitro tabs on their person?

For those who are partially altered, able to protect their own airway, try to get a history from them. What's their affect like? Are they agitated? Quiet and kind of knocked down? Do they smell of aclohol, or is their breath fruity? What are their pupils like? Do they have friends nearby? What do the friends have to say about how they normally are? Are they complaining of pain? Dizziness? Nausea?

As a first responder, you can start gathering info, even though you can't provide many interventions.

I sense a hunger here to know more... have you considered going past the first responder level?

Wendy

CO EMT-B

[musicislife]

In response to the first reply...i would look around for things in the environment (ie smoke, bottles)...i would look for signs of intoxication, determine from dispatch info if they had a seizure, assess for hypoglycemia (no BGL avaliable sadly), bottles (mentioned earlier, overdose. Try to determine if theyre on medications like anti depressants and determine if they already took them that day....then I would look for obvious signs of trauma..this is me thinking of the possibilites that my book gives for mental status.

[paramedicmike]

How old are you? I think knowing your age could help explain a few things here.

[musicislife]

15, why?

[Eydawn]

The way you write indicates that you are younger, with less experience. You're used to having teachers/others tell you what the right answer is. We're all about self directed learning here! ;-)

Wendy

CO EMT-B

[paramedicmike]

It addresses the issue surrounding your apparent lack of critical thinking skills and heavy reliance on "the book said/doesn't say".

Don't think I'm criticizing you. I'm not. Critical thinking is a skill you'll develop as you mature. It'll also develop the longer you're in the business. But it isn't going to hurt you to start practicing now. Besides, it's practical to just about every aspect of life even while you're still in high school.

As Wendy mentioned we're big on self directed learning here. You're taking steps to learn the material you're studying. However, you'll need to work on looking up answers first and then asking questions you either can't find an aswer to or need clarification on. Asking people here doesn't count. Google is your friend. If your Google-fu is weak then we can help direct you.

This site is a valuable resource. However, it isn't your only resource. While you're used to teachers just giving you the answer you can expect many of us here to make you work a little harder for the answer.

Keep working. Keep learning. Keep asking questions. Just be prepared to have done your homework prior to asking questions. You're off to a good start. Carry that momentum forward.