Altered Mental Status (AMS)

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% 25 gm IVP.
  • If blood sugar < 100 and unable to obtain IV access, GLUCAGON 1 mg IM or IN.
    • If patient is between 10 kg (22lb) - 20 Kg (44lb) .5 mg IM or IN.
    • Call for dosage order in pediatrics < 10 kg (22lb)
  • Refer to HYPO / HYPERGLYCEMIA PRACTICE PARAMETERS (5.10).
  • For pediatric administration dilute DEXTROSE 50% to DEXTROSE 25% and refer to Broselow Tape.
• If no response and a narcotic overdose is suspected:
  • An adult patient’s weight is < 50 kg, 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, NALOXONE (NARCAN) in 0.5 mg increments IVP or IN every 3 minutes prn if transient response observed, 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 Broselow Tape for pediatric administration of NALOXONE (NARCAN).