Altered Mental Status (AMS): Difference between revisions

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* Draw blood tubes, if available.
* Draw blood tubes, if available.
* If hypotensive, refer to [[Shock|SHOCK PRACTICE PARAMETER]] (5.13).
* If hypotensive, refer to [[Shock|SHOCK PRACTICE PARAMETER]] (5.13).
* If blood sugar < 100, [[Antidiabetics|DEXTROSE 50%]] 25 gm IVP.  
* If blood sugar < 100, [[Dextrose_50%25|DEXTROSE 50%]] OR [[Dextrose_10%25|DEXTROSE 10%]] 25 gm IVP.  
**If blood sugar < 100 and unable to obtain IV access, [[Antidiabetics|GLUCAGON]] 1 mg IM or IN.  
**For pediatric patients, refer to Handtevy System
***If patient is between 10 kg (22lb) - 20 Kg (44lb) .5 mg IM or IN.
**If blood sugar < 100 and unable to obtain IV access, [[Glucagon|GLUCAGON]] 1 mg IM or IN.  
***Call for dosage order in pediatrics < 10 kg (22lb)
**Refer to [[Hypo or Hyperglycemia|HYPO / HYPERGLYCEMIA PRACTICE PARAMETERS]] (5.10).  
**Refer to [[Hypo or Hyperglycemia|HYPO / HYPERGLYCEMIA PRACTICE PARAMETERS]] (5.10).  
**For pediatric administration dilute [[Antidiabetics|DEXTROSE 50%]] to [[Antidiabetics|DEXTROSE 25%]] and refer to Broselow Tape.
*If no response and a narcotic overdose is suspected:
*If no response and a narcotic overdose is suspected:
** An adult patient’s weight is < 50 kg, [[Antagonists|NALOXONE (NARCAN)]] in 0.5 mg increments IVP or IN every 3 minutes prn if transient response observed, not to exceed 6 mg.
** An adult patient’s weight is < 50 kg, Titrate [[Naloxone|NALOXONE (NARCAN)]] to effect, not to exceed 6 mg.
** An adult patient’s weight is > 50 kg, [[Antagonists|NALOXONE (NARCAN)]] in 0.5 mg increments IVP or IN every 3 minutes prn if transient response observed, not to exceed 10 mg.
** An adult patient’s weight is > 50 kg, Titrate [[Naloxone|NALOXONE (NARCAN)]] to effect, not to exceed 10 mg.
**'''Note: Only administer enough [[Antagonists|NALOXONE (NARCAN)]] to improve respiratory effort if decreased, it is not necessary to reverse the altered mental status. Consider soft restraints for the patient suspected of a narcotic overdose.'''
**'''Note: Only administer enough [[Naloxone|NALOXONE (NARCAN)]] to improve respiratory effort if decreased, it is not necessary to reverse the altered mental status. Consider soft restraints for the patient suspected of a narcotic overdose.'''
**'''Refer to Broselow Tape for pediatric administration of [[Antagonists|NALOXONE (NARCAN)]].'''
**'''Refer to Handtevy System for pediatric administration of [[Naloxone|NALOXONE (NARCAN)]].'''
 
[[Category:Medical|0503]]

Latest revision as of 00:26, 24 April 2020

Section 5 -MEDICAL 5.03

ALTERED MENTAL STATUS (AMS)

AMS is defined as an alteration in either the patient’s LOC or Orientation

INITIAL MEDICAL CARE (2.01) - Provide OXYGEN or assist ventilations as appropriate for patient condition.

  • C-spine precautions as indicated.
  • Obtain and record blood sugar level.
  • Draw blood tubes, if available.
  • If hypotensive, refer to SHOCK PRACTICE PARAMETER (5.13).
  • If blood sugar < 100, DEXTROSE 50% OR DEXTROSE 10% 25 gm IVP.
  • If no response and a narcotic overdose is suspected:
    • An adult patient’s weight is < 50 kg, Titrate NALOXONE (NARCAN) to effect, not to exceed 6 mg.
    • An adult patient’s weight is > 50 kg, Titrate NALOXONE (NARCAN) to effect, not to exceed 10 mg.
    • Note: Only administer enough NALOXONE (NARCAN) to improve respiratory effort if decreased, it is not necessary to reverse the altered mental status. Consider soft restraints for the patient suspected of a narcotic overdose.
    • Refer to Handtevy System for pediatric administration of NALOXONE (NARCAN).
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