Some patients have a baseline of less than 4. If a person cannot answer all 4 questions correctly, that does not mean that they are having an emergency. Next, you need to try to find out what their baseline orientation level is. If they know less than four, then they are alert and oriented x (the number of questions out of 4 they answer correctly), and have an altered mental status. If they know all four, then they are considered alert and oriented x 4, and do likely do not have an altered mental status. And what the event is(example: if they were shopping at the grocery store, see if they are aware of that). If I believe that they may have an altered mental status, I will ask them 4 questions ( person, place, time, event) 1. If they are disoriented, I consider them to have an altered mental status, and they may be having an emergency. Second, if patient is Alert/Awake, I evaluate if the patient is oriented or disoriented. Any person that is not alert or will not become alert (a person that you just woke up out of a sleep may need a little time to become alert) can be considered to have an altered mental status, and is possibly having a medical emergency. If a person will not respond to any stimuli, they are considered Unresponsive. a sternal rub), then they are considered responsive to pain. If a person is unconscious, and wont respond to any verbal stimuli, but have some sort of response to pain (i.e. If a person is unconscious, and will somewhat respond to verbal stimuli, but not wake up, they are considered responsive to Verbal Stimuli. If a patient is awake, they are considered alert. Next, I will show you what I am looking for when I am evaluation a person who I think may have an altered mental status.įirst, I evaluate the person’s level of responsiveness on the AVPU scale (Alert, Verbal, Pain, Unresponsive). Diabetic-Low/High blood glucose level (blood sugar).Here’s a list of some of the reasons of AMS: For example, a person may appear to be very drunk when they have low blood sugar level. Since it is difficult to know what is causing a person’s reason for AMS, it is best not to assume what is causing it. There are many reasons for a person to have an altered mental status (AMS). First, here are some possible reasons for an altered mental status. I will show you in this article what I am looking for when I am evaluating a patient with an altered mental status (AMS). It may be difficult/impossible to know if they are having an emergency or not, and it is usually best to err on the side of caution and assume they are having an emergency until proven otherwise. A person with an altered mental status may or may not be having an emergency.
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