Joyce Campbell – Altered Mental Status

Attention Health Care Professionals Your vital role is to identify and assist with the resolution of patients with altered mental state. Your life may depend on how well you treat patients with altered mental state.

Joyce Campbell – Altered Mental Status

Life-Threatening Causes of AMR: Get ready to intervene

• Hypoxia and CNS symptoms may be caused by problems in the airways.
• Gross assessment of disability (GCS or AVPU)
• Rapid head-to-toe assessment
• Find quickly fixable causes
• History and physical… Asking the right questions
• Diagnostic work-up
• Coma and altered consciousness: Brain stem, cerebral hemispheres
• Predictive model of the risk for delirium in older hospitalized patients
• Intensive care delirium scanning checklist
• Confusion Assessment Method
• Practice Alert – AACN
• Break down: Psychosis, dementia, Delirium

Common Conditions can cause Delirium

• Medicines – Interactions and adverse effects
  • Central agents acting as agents
  • Sedative hypnotics
  • Anticonvulsants
  • Analgesics
  • GI agents
  • Antinauseants
  • Antibiotics
  • Psychotropic meds
  • Cardiac meds
  • OTC meds
  • Steroids

• Medicines – withdrawal syndromes
• UTI
• Pneumonia
• Electrolyte disorders
• Endocrine crisis: Hyper/hypothyroid, adrenal, diabetic, Wilson’s disease
• Korsakoff syndrome
• Transient global amnesia
• Pain agitation

10 Years of Life-Threatening Conditions Causing Delirium

• Hypoxia
• Hypoglycemia
• Encephalopathy: Hypertensive and Werniche’s
• Drug overdose
• Acute neuro: Meningitis, SAH and seizures
• CNS trauma
• Sepsis

Delirium: Don’t Forget These Possibilities:

• A patient suffering from delirium due to structural changes
• Subdural hematoma
• Brain tumor
• Hydrocephalus at normal pressure
• Stroke
• SEPSIS and infectious disease: The ticking bomb
• Meningitis, Encephalitis are not to be missed

Psychosis into Madness

• Major depressive disorder
• PHQ-9 Screening Instrument
• Post-partum depression
• Bipolar
• Schizophrenia
• Schizoaffective
• Hallucinations, illusions, and delusions
• Both positive and negative clinical manifestations
• Other treatments and pharmacology
• Personality Disorders
• Schizotypal Disorder
• Global amnesia: A case study

Dementia and the Work-Up

• Histories
• Mini mental
• Sweet 16 Cognitive assessment tool
• Radiological diagnostic work-Up
• Delirium plus dementia
• Alzheimer work-Up
• Lewy body
• Chronic traumatic Encephalopathy

Interventions to Common Problems

• Memory loss and confusion
• Concentration reduced
• Hallucinations
• Agitation
• Sleep disturbance
• Inability to complete ADLs

Expanding the Care Window: Current Research

Would you like to be contacted? Joyce Campbell – Altered Mental Status ?

Description:

• Diagnostic challenges: Possible involvement of one or several body systems
• Life is yours-Interventions to treat or prevent delirium
• To diagnose the cause, we need to examine your entire body.
• Get the most current EBP information for dementia treatment
• Keep an eye out for drugs and diseases that may cause AMS.
• What about the mentally ill patients with delirium?

Attention Health Care Professionals! You can play an important role in diagnosing and helping to solve problems that affect patients with altered mental state. Your life may depend on how well you treat patients with altered mental state.

Delirium… Dementia… Psychosis

No doubt, you’ve said it when confronted with a patient with an altered mental state. “What is going on?” It’s time to STOP, LISTEN and LOOK, then ACT. This seminar will examine altered mental status (AMS), in order to identify the problem, and then lead to solution. Studying AMS is similar to taking a combination med.-Neuropsychiatric and surg courses, because one must consider all systems of the body when assessing potential causes for AMS.

Every day, patients present with altered mental status in a variety of settings….ED, ICU, med/surg, geriatric, psych units, rehab, long-term care. There are many other options. The patient may save their life by connecting the dots and identifying the problem. Your patient with a mental disorder will be able to use your new assessment tools and strategies.