She was unable to attend and required redirection throughout the interview. She was oriented to person only and responded appropriately to simple questions, intermittently following one-step commands. Oxygen (O 2) saturation was 96% on room air. Initial vital signs were: heart rate, 110 beats/minute respiratory rate, 12 breaths/minute blood pressure, 163/103 mm Hg oral temperature, 98.2 ˚F. On arrival to the ED, the patient appeared comfortable in bed. She was unable to provide any meaningful history. There were no reported changes to the patient’s medications which included aspirin, levothyroxine, and hydrochlorothiazide. The aide activated 911 on the direction of the patient’s primary care physician. For the past few days, the patient’s appetite waned, and she became progressively more lethargic, not eating for over 24 hours. 2010 56(4):382-388.Ī 100-year-old woman with a history of hypertension, hypothyroidism, and moderate Alzheimer dementia was brought to the ED by emergency medical services (EMS) for altered mental status after her home health aide (HHA) noted a change in the patient’s behavior. Performance of the RAD-57 pulse CO-oximeter compared with standard laboratory carboxyhemoglobin measurement. Touger M, Birnbaum A, Wang J, Chou K, Pearson D, Bijur P.Hyperbaric therapy for acute carbon monoxide poisoning. Weaver LK, Hopkins RO, Chan KJ, et al.Evaluation of the Confusion Assessment Method (CAM) as a screening tool for delirium in the emergency room. Monette J, Galbaud du Fort G, Fung SH, et al.The Confusion Assessment Method: a systematic review of current usage. Wei LA, Fearing MA, Sternberg EJ, Inouye SK.Clarifying confusion: the confusion assessment method. Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI.Improving emergency department identification and management of agitated delirium in older adults: Implementation and impact assessment of a comprehensive clinical protocol using an A-B-C-D-E-F mnemonic. Decision Making in Emergency Critical Care: An Evidence-Based Handbook. In: Arbo JE, Ruoss SJ, Lighthall GK, Jones MP, eds. Predictive model and interrelationship with baseline vulnerability. Precipitating factors for delirium in hospitalized elderly persons. Delirium in older emergency department patients: recognition, risk factors, and psychomotor subtypes. Han JH, Zimmerman EE, Cutler N, et al.
Delirium in the older emergency department patient: a quiet epidemic. Washington, DC: American Psychiatric Association 2013.
A patient with an altered mental status is manual#
Diagnostic and Statistical Manual of Mental Disorders.
0 kommentar(er)
