ED Pathway for Evaluation/Treatment of Children with Behavioral Health Issues

Differential Diagnosis

Altered Mental Status

A Alcohol
E Endocrine, Encephalopathy, Electrolytes
I Insulin (hypoglycemia)
O Oxygen (hypoxia), Opiates (drugs of abuse)
U Uremia
T Toxicants, Trauma, Temperature
I Infection
P Psychiatric, Porphyria
S Stroke, Shock, Subarachnoid Hemorrhage
Space‐Occupying CNS Lesion
V Vascular – stroke, atypical migraine
I Infection – CNS, sepsis
T Trauma – Hemorrhage, concussion
A A lot of toxicants
M Metabolic – hyperammonemia, thryotoxocosis, hypo/hyperglycemia, heat stroke, uremia
I Intussusception
N Neoplasm
S Seizure, post-ictal