Behavioral Health Issues Clinical Pathway — Emergency Department
Behavioral Health Issues Clinical Pathway — Emergency Department
Review Differential Diagnosis for Altered Mental Status and Psychosis
Causes of Altered Mental Status
AEIOU-TIPS
A | Alcohol |
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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 |
VITAMINS
V | Vascular — stroke, atypical migraine |
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I | Infection — CNS, sepsis |
T | Trauma — hemorrhage, concussion |
A | A lot of toxicants |
M | Metabolic — hyperammonemia, thyrotoxicosis, hypo/hyperglycemia, heat stroke, uremia |
I | Intussusception |
N | Neoplasm |
S | Seizure, post-ictal |
Psychosis
Disruption in thinking, accompanied by delusions or hallucinations
Organic | Drug Toxicity | Non-organic |
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Further Diagnostic Testing
Screening for Organic Disease
Studies | Lab |
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Blood |
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Urine |
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Toxicology |
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Hormonal |
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Imaging |
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CSF | Lumbar puncture, if concern for encephalopathy/encephalitis |