"The Altered Mental Status Patient" is an engrossing example of a paper on the disorder. Brain needs for survival, the 1-minute “ 4P assessment” , and the different differential diagnoses are the most interesting things that I read for this session. This is because brain needs topic was presented in a simple and well-understood manner, “ 4P Assessment” had offered information that one can determine sickness in just one minute, and differential diagnoses delineated guides or clues that would quickly identify multisystem effects of different health conditions to altered mental status. While reading the topics, there are three main things I learned from this session: the major causes of altered mental status, the paramedic ways of assessing patients with or at risk with altered mental status, and the critical signs of determining sickness. Before reading the topic, I thought that it is impossible to assess the degree of a person’ s sickness in just one minute.
I also thought that in assessment, the pleuritic part of assessment must be addressed first before perfusion and that the presence of anterograde amnesia must be assessed first before the presence of retrograde amnesia.
I learned that these things are untrue because using the “ 4P Assessment” , a paramedic can determine the degree of sickness in just one minute; perfusion must be addressed first to determine shock, pulse, and uncontrolled bleeding will be early detected if perfusion is assessed first, and alertness of past events will be established if retrograde amnesia is assessed first before anterograde amnesia. I thought that we would have covered paramedics’ interventions in altered mental status because aside from theory, the application is also important in this topic.
I also thought that since we have general guidelines for assessing patients with altered mental signs, specific warning signs of impending alterations in mental status would have been covered. In addition, I thought that more examples, for instance, a clinical scenario, will be provided because topics deal with different assessment tools and guidelines. I found the categorization of sickness (sick, sick, very sick, dead) new because I only thought that it is either between sick or not sick category. The AEIOU TIPS is also surprising learning because I only encountered complex concepts discussing common causes of altered mental status.
The interview guideline is also new to me as I’ ve never encountered it before. I have changed my mind regarding priority assessment because I learned from this topic that perfusion must be addressed first in determining altered mental status. I may also be able to use the interview guidelines for future patients with alterations in mental status. I am still unsure about when to categorize symptomatic vs. asymptomatic, acute vs. non-acute, and stable vs. unstable because I think these languages have all the same meaning.
The thing that I liked most is the topic about brain needs for survival because of simple presentation while I disliked differential diagnosis presentation because of complexity. Meanwhile, two issues that interest me a lot to study in more detail are the differences in symptomatic vs. asymptomatic, acute vs. non-acute, and stable vs. unstable because of problems in clarity and the priority interventions (whether perfusion or pleuritic) because I really feel that pleuritic which has descriptions of the airway, must be addressed first. Multiple Choice Questions: What is the first objective sign of hypoxemia? Syncope Dizziness Dyspnea Altered mental status Answer: (D).
Altered mental status is the first objective sign of hypoglycemia (Beebe & Myers, 2011, p. 255). What is the priority intervention if patients with altered mental status are found not breathing? Gather additional information. Place the victim in the recovery position. Perform CPR. Perform rescue breathing Answer: (D). A victim with altered mental status and is not breathing must be given rescue breathing. If circulation is absent, CPR is needed. Placing the patient in the recovery position and keeping the airway open is for victims who are breathing.
Gathering additional information is not a priority intervention but an initial intervention (Thygerson, 2005, p. 266).
Beebe, R. and Myers, J. (2012). Trauma Resuscitation. Professional Paramedic: Trauma, Care, and EMS Operations, Vol. III. New York: Delmar, Cengage Learning, pp. 248-256.
Thygerson, A.L. (2005). Sudden Illnesses. First Aid, CPR, and AED, 4th ed. Massachusetts: Jones and Bartlett Publishers, Inc., pp. 257-282.