Altered LOA Flashcards
(161 cards)
1
Q
What does the AEIOU TIPS mnemonic stand for in altered LOA assessment?
A
A: Arrhythmia, Alcohol, Acidosis
E: Endocrine, Electrolytes, Encephalopathy
I: Insulin (hypo/hyperglycemia)
O: Oxygen, Overdose
U: Uremia
T: Trauma, Tumor, Thermal
I: Infection
P: Poisoning, Psychiatric
S: Syncope, Stroke, Seizure
2
Q
How do arrhythmias cause altered LOA?
A
Impaired perfusion to the brain due to inefficient cardiac output can cause hypoxia and neurological changes.
3
Q
What is the treatment for suspected arrhythmia causing altered LOA (BLS)?
A
Monitor rhythm, assess for perfusion issues, prepare defibrillator pads, and support ABCs. Refer to the Tachydysrhythmia directive if applicable (ALS).
4
Q
How does alcohol cause altered LOA?
A
It increases GABA (inhibitory) and suppresses glutamate (excitatory), depressing CNS activity.
5
Q
Key signs to assess for alcohol intoxication?
A
Odor of alcohol, slurred speech, uncoordinated, unresponsive, altered pupils, respiratory depression.
6
Q
How does metabolic acidosis affect LOC?
A
Low pH from acid buildup causes CNS depression and neurologic symptoms.
7
Q
How can electrolyte imbalance affect LOA?
A
Disrupts neuron firing (especially Na⁺, K⁺, Ca²⁺), causing confusion, weakness, or seizures.
8
Q
BLS interventions for suspected electrolyte issue?
A
Supportive care, oxygen if indicated, temperature assessment, IV access (ALS), transport.
9
Q
What is hepatic encephalopathy and how does it alter LOA?
A
Liver failure leads to ammonia buildup, impairing brain function—causes confusion, asterixis, or coma.
10
Q
S/S of hypoglycemia?
A
Sweating, tremors, tachycardia, confusion, aggression, seizure, unconsciousness.
11
Q
S/S of hyperglycemia/DKA?
A
Polyuria, polydipsia, fruity breath, abdominal pain, Kussmaul respirations, altered LOC.
12
Q
ALS treatment for hypoglycemia in altered LOA?
A
Confirm BGL <4 mmol/L
Administer Dextrose IV or Glucagon IM
Reassess BGL post-treatment
BLS: maintain airway, transport, monitor vitals
13
Q
How do you differentiate DKA from HHS?
A
DKA: Ketones, acidosis, Type 1 DM
HHS: Extremely high glucose, no ketones, Type 2 DM, more dehydration and altered LOC
14
Q
How does hypoxia contribute to altered LOA?
A
Lack of O₂ impairs brain function, leading to confusion, restlessness, or unresponsiveness.
15
Q
BLS treatment for oxygen-related altered LOA?
A
Maintain SpO₂ 92–96% (or 88–92% for COPD)
Administer high-concentration O₂ for burns, CO poisoning, cardiac arrest
Prepare to ventilate.
16
Q
ALS treatment for opioid overdose with altered LOA?
A
Administer Naloxone (Narcan) as per Opioid Toxicity Medical Directive
Support airway and breathing.
17
Q
How does renal failure lead to altered LOA?
A
Accumulation of toxins and metabolic acidosis impair CNS function.
18
Q
Assessment questions for uremia?
A
History of kidney disease, dialysis, urine output, swelling, fatigue.
19
Q
How does trauma affect LOA?
A
Causes increased ICP or hypovolemia leading to cerebral hypoperfusion.
20
Q
BLS treatment for thermal exposure causing altered LOA?
A
Heat: Cool the patient, remove clothing, apply cold packs
Cold: Warm gradually, wrap body, avoid rubbing frozen skin.
21
Q
How can infection cause altered LOA?
A
Inflammatory response impairs neuronal function, common in sepsis, meningitis, UTI.
22
Q
BLS treatment for suspected sepsis-related altered LOA?
A
Monitor ABCs
Consider sepsis alert
Obtain temperature, vitals
Rapid transport.
23
Q
S/S of anticholinergic poisoning?
A
Dry skin, dilated pupils, hallucinations, tachycardia, urinary retention.
24
Q
ALS treatment for opioid or sedative OD?
A
Naloxone (opioids), supportive airway care (benzos), avoid over-sedation with poly-substance use.
25
How do psychiatric conditions alter LOA?
Neurochemical imbalance leads to disorientation, hallucinations, disorganized thought, or catatonia.
26
How to differentiate seizure from syncope?
Seizure: Tonic-clonic activity, postictal phase, tongue biting
Syncope: Quick recovery, brief LOC, no confusion.
27
Stroke vs. hypoglycemia in altered LOA?
Stroke: Focal deficits (slurred speech, weakness)
Hypoglycemia: Diffuse signs (confusion, sweating, hunger, neuroglycopenic).
28
BLS treatment for seizure patient?
Protect airway and patient from injury
Observe seizure characteristics
Place in recovery position postictal
Monitor for hypoxia and transport.
29
What are key components of the Acute Stroke Bypass Protocol?
LAMS score ≥4
Symptom onset <6h
No contraindications (seizure, BGL <3, GCS <10)
Transport to EVT/designated stroke centre.
30
What are signs that arrhythmia may be contributing to altered LOA?
Irregular pulse, syncope, dizziness, palpitations, low BP, cyanosis, and altered mentation.
31
ALS care for arrhythmia-related LOA (if hemodynamically unstable)?
Follow Tachydysrhythmia Medical Directive — prepare for cardioversion, monitor cardiac rhythm, ensure airway/oxygenation.
32
What key vitals may indicate metabolic acidosis as the cause of altered LOA?
Tachypnea (compensatory), Hypotension, Kussmaul breathing (especially in DKA), Warm, flushed skin (early stages).
33
What assessments are important for endocrine-related altered LOA?
Ask about thyroid disorders, adrenal insufficiency. Check temperature and skin signs (e.g., myxedema). Assess for signs of Addisonian crisis (hypotension, weakness, confusion).
34
Signs that altered LOA may be due to electrolyte disturbance?
Muscle cramps, tetany, seizures. ECG changes (peaked T waves = hyperkalemia). Confusion, lethargy.
35
What directive is followed for altered LOA with seizures from hyponatremia or hypocalcemia?
Seizure Standard (BLS) + Consider underlying metabolic cause, protect airway, provide oxygen, prepare for transport.
36
What clues point toward hepatic encephalopathy as the cause of altered LOA?
History of liver disease, Jaundice, ascites, Asterixis (liver flap), Ammonia odor on breath.
37
What makes toxic encephalopathy different from other types?
It is caused by exposure to medications, drugs, or poisons—may present with confusion, hallucinations, seizures, or coma.
38
What is Whipple’s Triad and why is it important?
Hypoglycemic symptoms, BGL <4 mmol/L, Relief after glucose treatment. Used to confirm hypoglycemia as cause of altered LOA.
39
ALS treatment for a hypoglycemic patient with decreased LOA?
D10W or D50 IV if IV access. Glucagon IM if no IV. Reassess BGL in 10 minutes. Prepare for recurrent hypoglycemia or airway compromise.
40
How do you differentiate opioid toxicity from benzodiazepine toxicity in altered LOA?
Opioids: Pinpoint pupils, respiratory depression, responsive to Naloxone. Benzos: Sedation, altered LOA, but normal pupils, no reversal in prehospital setting.
41
What is the BLS protocol for suspected CO poisoning?
Administer high-concentration O2 regardless of SpO2. Remove patient from source. Monitor ABCs. Consider multiple patients with same symptoms in enclosed space.
42
How does uremia contribute to altered LOA?
Accumulation of toxins (e.g., urea, creatinine) affects brain function → confusion, seizures, or coma.
43
What vitals and findings are associated with uremia?
Hypertension, Signs of fluid overload, Decreased urine output, Uremic frost or breath odor.
44
What signs may suggest increased ICP in trauma-related LOA?
Decreased GCS, Unequal pupils, Cushing's Triad: ↑BP, ↓HR, irregular RR, Vomiting, posturing.
45
Key difference between heat exhaustion and heat stroke in altered LOA patients?
Heat exhaustion: Sweaty, mildly altered, normal temp. Heat stroke: Dry or hot skin, severe AMS, temp >40°C.
46
ALS treatment priorities for severe hypothermia with altered LOA?
Handle gently. Avoid unnecessary suctioning. Begin rewarming only externally. Prepare for possible VF if moved roughly.
47
How does UTI cause altered LOA in elderly patients?
Causes systemic inflammation without typical fever. Leads to confusion, delirium, and agitation.
48
What are BLS signs that suggest sepsis as the cause of altered LOA?
Fever or hypothermia, Tachycardia, Hypotension, Confusion, Delayed cap refill.
49
What toxidrome is associated with organophosphate poisoning and altered LOA?
SLUDGE-M (Salivation, Lacrimation, Urination, Diarrhea, GI upset, Emesis, Miosis). Seizures, bradycardia, respiratory failure.
50
In a psychiatric altered LOA, what should be ruled out first?
Organic causes: hypoglycemia, trauma, OD. Then consider psychiatric (schizophrenia, bipolar, dementia).
51
What symptoms suggest hyponatremia is causing altered LOA?
Headache, nausea, confusion, seizures, weakness — often with low serum sodium.
52
What conditions lead to hyperkalemia and altered LOA?
Renal failure, DKA, certain meds (e.g., ACE inhibitors). May present with bradycardia, weakness, and peaked T waves.
53
BLS care for suspected electrolyte imbalance?
Manage ABCs
Oxygen as indicated
Supportive care
Rapid transport for definitive treatment
54
What are signs of Wernicke encephalopathy in altered LOA?
Confusion, ataxia, and ophthalmoplegia — commonly in alcoholics due to B1 (thiamine) deficiency.
55
What assessment findings suggest hypertensive encephalopathy?
Severe HTN, headache, vomiting, visual disturbances, confusion, seizures.
56
How is hepatic encephalopathy differentiated from uremic encephalopathy?
Hepatic: history of liver disease, asterixis, elevated ammonia
Uremic: renal failure, fluid overload, uremic frost, metabolic acidosis
57
How can Addisonian crisis cause altered LOA?
Cortisol deficiency causes hypotension, confusion, vomiting, and possibly shock.
58
Signs of myxedema coma (severe hypothyroidism)?
Bradycardia, hypothermia, respiratory depression, confusion, swelling of face/tongue.
59
What are BLS interventions for suspected endocrine crisis?
Oxygen support
Passive warming if hypothermic
Monitor vitals
Rapid transport
60
How do you differentiate between hypoxia and hypercapnia as cause of altered LOA?
Hypoxia: agitation, cyanosis, tachypnea
Hypercapnia: confusion, flushed skin, headache, bradypnea
61
What SpO₂ should be targeted in COPD patients with altered LOA?
88–92%, unless otherwise directed (ALS may adjust based on patient presentation).
62
When do you give high-concentration oxygen in altered LOA?
Suspected CO poisoning, cyanosis, SpO₂ unavailable, or signs of respiratory failure.
63
Signs of stimulant overdose contributing to altered LOA?
Agitation, hyperthermia, tachycardia, seizures, mydriasis, delirium.
64
How do you differentiate opioid toxicity from sedative-hypnotic overdose?
Opioids: pinpoint pupils, respiratory depression, responds to naloxone
Sedatives: altered LOA but normal pupils, usually no reversal agent prehospital
65
ALS care for poly-substance overdose?
Naloxone if opioids suspected
Support ABCs
Prepare for emesis, aspiration
Consider BHP consultation
66
What skin signs help differentiate heat exhaustion from heat stroke?
Exhaustion: sweaty, cool skin
Stroke: dry/hot skin, altered mental status
67
What vitals suggest hypothermia is contributing to altered LOA?
Bradycardia, bradypnea, hypotension, decreased LOC, cold stiff limbs.
68
When should you withhold oral fluids in a heat-related altered LOA?
If patient is vomiting, has decreased LOC, or if heat stroke is suspected.
69
What are signs of seizure-related altered LOA?
Postictal confusion
Tongue trauma
Incontinence
Witnessed tonic-clonic activity
70
What indicates syncope rather than seizure?
Sudden onset, short duration, rapid full recovery, no postictal state, often situational.
71
What is the role of LAMS in stroke assessment?
Scored 0–5
LAMS ≥4 = LVO positive → transport to EVT center (if <6h and eligible)
72
What stroke symptoms require hyperventilation per BLS?
GCS <9 + signs of cerebral herniation (e.g., posturing, blown pupils) despite correcting hypoxia/hypotension.
73
When do you not use the stroke bypass protocol?
BGL <3
GCS <10
Airway not protected
Symptoms resolved
Active seizure on arrival
Transport time >2h
74
What cause of altered LOA is likely if patient is: flushed, warm, tachycardic, dry mouth?
Anticholinergic poisoning or hyperglycemia.
75
What cause is suspected if patient is pale, clammy, hypotensive, diaphoretic, bradycardic?
Hypoglycemia or opioid overdose.
76
What condition is most likely if RR is deep and rapid (Kussmaul), BGL >14 mmol/L, and fruity breath odor?
Diabetic ketoacidosis (DKA).
77
What vitals suggest sepsis as the cause of altered LOA?
Fever or hypothermia, tachycardia, hypotension, tachypnea, confusion.
78
What is the general BLS approach for all altered LOA patients?
Protect airway
Support breathing
Oxygen as needed
Check BGL
Rule out trauma
Secondary survey
Transport promptly
79
What ALS directives apply to altered LOA from hypoglycemia?
Hypoglycemia Medical Directive — Dextrose IV or Glucagon IM, reassess and recheck BGL.
80
What ALS directive is followed for opioid overdose causing altered LOA?
Opioid Toxicity Directive — Administer Naloxone, titrate to RR improvement, max 3 doses IM or 2 IV/IN.
81
What directive helps guide care for altered LOA from unknown toxic exposure?
Toxicological Emergency Standard — attempt to ID substance, support ABCs, anticipate seizures/arrest.
82
What scene clues may indicate opioid overdose?
Paraphernalia (syringes, spoons, rubber ties), unresponsive patient, pinpoint pupils, respiratory depression, cyanosis.
83
What questions help differentiate diabetic emergency from stroke in altered LOA?
Onset of symptoms, Medications (insulin/oral), BGL level, Slurred speech vs general confusion, Unilateral weakness (stroke-specific).
84
What clues help you differentiate infection as a cause of altered LOA?
Fever or hypothermia, Urinary catheter or wound, History of recent illness or antibiotic use, Confusion (especially elderly).
85
What should you look for in patients with suspected psychiatric vs toxicologic causes?
Psychiatric: baseline history, bizarre behavior, no smell or toxidrome. Toxicologic: chemical odor, altered vitals, SLUDGE symptoms or pinpoint pupils.
86
What are important SAMPLE history questions for altered LOA?
Seizure/diabetic/psychiatric history, Allergies (anaphylaxis?), Medications (insulin, benzos, antipsychotics, opioids), Last meal/use, Events leading up to episode.
87
Pupils: pinpoint, unresponsive — what’s likely cause?
Opioid overdose.
88
Pupils: dilated, agitated, dry skin — likely cause?
Anticholinergic toxidrome (e.g., antihistamines, tricyclics).
89
Breath: fruity odor, tachypnea, dehydration signs — likely cause?
DKA (diabetic ketoacidosis).
90
Patient is flushed, febrile, hypotensive, altered — likely cause?
Septic shock.
91
Sudden LOA drop with known seizure history, postictal confusion — likely cause?
Seizure/postictal state.
92
Unconscious, cyanotic, gas generator in room — likely cause?
Carbon monoxide poisoning.
93
Sudden collapse, no radial pulse, irregular wide complex rhythm — likely cause?
Ventricular tachycardia or fibrillation (cardiac arrhythmia).
94
BP: 90/60, HR: 48, RR: 8, Pupils: pinpoint — what’s the likely cause of altered LOA?
Opioid overdose.
95
BP: 170/110, HR: 68, RR: 20, temp: 38.9°C — patient confused, disoriented — likely cause?
Hypertensive encephalopathy or infection (sepsis) if febrile.
96
BP: 84/60, HR: 130, RR: 28, temp: 35°C, dry mucosa — likely cause?
Severe dehydration from DKA or HHS.
97
BP: 150/100, HR: 110, RR: 30 (Kussmaul), fruity breath — what's the cause?
Diabetic ketoacidosis.
98
BP: 100/60, HR: 95, RR: 26, SpO₂: 87% on RA — patient has productive cough, confusion — likely cause?
Pneumonia-induced hypoxia.
99
BP: 140/90, HR: 72, RR: 16, SpO₂: 99% — patient is unresponsive with sudden onset facial droop — likely cause?
Ischemic stroke.
100
What BLS care is provided for unresponsive patient with possible hypoglycemia?
Check BGL, Maintain airway, Consider OPA/NPA, Prepare suction, Request ALS backup.
101
When should you administer naloxone as a PCP?
When opioid toxicity is suspected, with respiratory depression and altered LOA.
102
ALS treatment if BGL <4 mmol/L and patient is altered?
Administer D10W or D50 IV, Glucagon IM if no IV, Recheck BGL and reassess.
103
How do you manage a seizure in progress per BLS protocol?
Protect patient from harm, Recovery position post-seizure, Suction prn, Monitor vitals, Oxygen prn.
104
What is the first thing to rule out in any altered LOA patient?
Hypoglycemia (check BGL ASAP).
105
What BLS protocol is followed for hypothermic altered patient?
Remove from cold, Passive warming (blankets), Rewarm axilla/groin/neck, Avoid vigorous movement or suction.
106
What ALS directive applies to a suspected stimulant overdose?
Toxicological Emergency Directive – support ABCs, monitor vitals, manage seizures.
107
Stroke vs Hypoglycemia — key difference in LOC presentation?
Stroke: focal deficits, often alert; Hypoglycemia: diffuse confusion or unconsciousness.
108
Stroke vs seizure — how do you tell which caused the altered LOA?
Seizure: tonic-clonic activity, tongue bite, incontinence, postictal state; Stroke: sudden onset, facial droop, slurred speech, localized weakness.
109
Infection vs psychiatric condition — how do you differentiate altered LOA?
Infection: fever, abnormal vitals, inflammation; Psychiatric: flat affect, inconsistent story, baseline history.
110
Poisoning vs alcohol — how to tell the difference?
Poisoning: SLUDGE signs, organophosphate odor, bradycardia; Alcohol: GCS drops slowly, history supports, GABA effects.
111
What is the danger of giving glucose to a stroke patient mistakenly assumed to be hypoglycemic?
None if BGL <4; however, unnecessary glucose may delay appropriate stroke care.
112
Patient is found confused and agitated at a bus stop. He’s sweating profusely, pale, and says he skipped lunch. BGL: 2.4 mmol/L. What's the likely cause?
Hypoglycemia.
113
Unresponsive elderly woman. Temp: 39.4°C, RR: 30, HR: 122, BP: 88/60. GCS: 9. Likely differential?
Sepsis.
114
Middle-aged man, confused, talking to people not there. Skin flushed, pupils dilated, HR: 130, BP: 160/100. Dry mucosa. Toxidrome?
Anticholinergic poisoning.
115
Patient seizing. History of epilepsy. Brother says she stopped taking meds 3 days ago. What is the most likely cause?
Non-compliance leading to breakthrough seizure.
116
Teen found unconscious at a party. RR: 6, shallow. Pinpoint pupils. What intervention should you prepare?
Administer Naloxone for opioid overdose (ALS), support airway (BLS).
117
Elderly patient with Alzheimer’s, now severely disoriented with fever and foul-smelling urine. Likely cause?
UTI-induced delirium.
118
Patient has altered LOA, fruity odor on breath, deep rapid breathing, GCS 10. BGL: 26 mmol/L. Most likely condition?
Diabetic ketoacidosis (DKA).
119
Patient is trembling, sweaty, tachycardic. Skin pale and clammy. BGL: 3.6 mmol/L. Mental status improving after juice. Diagnosis?
Mild hypoglycemia (confirmed via Whipple’s Triad).
120
30-year-old found confused after camping. Temp 33°C, HR 40, RR 10. Vitals deteriorating. What’s the BLS priority?
Handle gently, passive rewarming, oxygen, avoid unnecessary suction (suspected hypothermia).
121
40-year-old found post seizure. GCS 7, bleeding from tongue, incontinent, recovering slowly. What's the likely state?
Postictal phase after generalized seizure.
122
Confusion + Tachycardia + Hypotension + Febrile = ?
Sepsis.
123
Confusion + Fruity breath + Tachypnea + Hyperglycemia = ?
DKA.
124
Sudden unconsciousness + Irregular pulse + No trauma = ?
Cardiac arrhythmia.
125
Confusion + Visual hallucinations + Dry mucosa + Hot skin + Tachycardia = ?
Anticholinergic poisoning.
126
Altered LOA + Pinpoint pupils + RR < 8 + Cyanosis = ?
Opioid overdose.
127
Dizziness + Upright posture + BP drop > 20 systolic = ?
Orthostatic hypotension.
128
Disorientation + Pale, sweaty skin + Normal BGL + Delayed cap refill = ?
Hypovolemia or early shock.
129
Agitation + SpO₂ 85% + Accessory muscle use + Cyanosis = ?
Respiratory failure or hypoxia-induced agitation.
130
Unresponsive + Warm/dry skin + High BGL + No ketones = ?
HHS (Hyperosmolar Hyperglycemic State).
131
Confusion + Yellow sclera + Distended abdomen + Asterixis = ?
Hepatic encephalopathy.
132
What are the treatment priorities for altered LOA due to seizure?
Protect airway
## Footnote
Recovery position post-seizure, Oxygen as needed, Monitor for re-seizure.
133
When would you avoid giving fluids to a patient with altered LOA?
If airway is unprotected and patient is vomiting or severely confused (risk of aspiration).
134
What should you do for a patient altered after head trauma, vomiting, unequal pupils?
Support airway, prepare to manage increased ICP (hyperventilate if GCS <9 and herniation signs), rapid transport.
135
In BLS care, what is the threshold to consider altered LOA as a critical finding?
Any sudden or progressive change in GCS, particularly if GCS <13 or AVPU = “U”.
136
When should cooling procedures be discontinued in a heat stroke patient?
Skin feels normal
## Footnote
Shivering begins, LOC improves.
137
BLS treatment for suspected carbon monoxide poisoning?
High-flow oxygen via NRB
## Footnote
Remove patient from source, Monitor ABCs, Transport to facility with hyperbaric capability if indicated.
138
ALS protocol for opioid overdose with respiratory arrest?
Manage airway
## Footnote
Provide BVM ventilation, Administer Naloxone IM/IN/IV as per directive, Reassess after 3–5 minutes.
139
BLS actions for a patient with altered LOA and suspected stroke?
Assess using LAMS
## Footnote
Check BGL, Rule out hypoglycemia, Determine symptom onset, Stroke bypass protocol if eligible.
140
When do you consider calling BHP for altered LOA?
Unclear etiology
## Footnote
Drug interactions, High-risk overdose, Need for consultation on unusual toxidrome.
141
What airway adjuncts are indicated in unresponsive altered LOA with no gag reflex?
OPA or NPA depending on contraindications.
142
50-year-old with GCS 6, unequal pupils, bradycardia, hypertension. History of fall. What is your primary concern?
Increased intracranial pressure with possible cerebral herniation.
143
Patient has GCS 10, history of schizophrenia, dry mouth, mydriasis, poor memory, hallucinations. Likely cause?
Antipsychotic medication toxicity or anticholinergic crisis.
144
Diabetic patient presents with rapid breathing, nausea, BGL: 30, pH: 7.2. What's happening?
DKA — treat per hypoglycemia directive and monitor acid-base balance.
145
Unresponsive elderly patient with no trauma, dry skin, flushed, BGL: 24, no ketones. Diagnosis?
HHS.
146
Agitated teen found with dilated pupils, high BP, sweating, and talking rapidly. Differential?
Stimulant use (e.g., cocaine, amphetamine).
147
90-year-old, fever, decreased urine output, confused, no trauma. No localizing signs. What is the likely cause?
UTI-induced delirium (sepsis in elderly).
148
19-year-old male found naked in hot room, seizing, dry skin, temp 42°C. Substance use suspected. What do you suspect?
Heat stroke from stimulant OD (e.g., MDMA/ecstasy).
149
Middle-aged man, hx of renal failure, now lethargic, slow speech, facial twitching. What do you suspect?
Uremic encephalopathy.
150
Sudden GCS drop after vomiting in elderly patient on warfarin. What's a major concern?
Intracranial bleed.
151
34-year-old has visual hallucinations, myoclonus, insomnia for 3 days. Altered and febrile. Top differential?
CNS infection (e.g., encephalitis).
152
What’s the first 4 assessments to do for any altered LOA patient?
Airway/Breathing
## Footnote
GCS, BGL, Pupils.
153
What is the best way to rule out reversible causes of altered LOA in prehospital setting?
Use AEIOU TIPS + check vitals, BGL, pupils, history, and scene clues.
154
Which AEIOU TIPS causes are most immediately reversible prehospital?
Insulin (hypoglycemia)
## Footnote
Overdose (opioids), Oxygen (hypoxia), Electrolytes (if supportive care given).
155
GCS <8, pupils blown, post-fall. What ventilation rate do you aim for per herniation protocol?
20 bpm (adult) — per BLS cerebral herniation guideline.
156
What key findings must be documented for all altered LOA patients?
GCS trend, vitals, BGL, interventions, response, SAMPLE/OPQRST, and any scene clues.
157
What is SLUDGE-M and when is it used?
Cholinergic toxidrome (Salivation, Lacrimation, Urination, Diarrhea, GI upset, Emesis, Miosis) — e.g., organophosphates.
158
What do pinpoint pupils + apnea + cyanosis + low HR = ?
Opioid overdose.
159
What is the number one priority in altered LOA regardless of cause?
Protect the airway.
160
What BGL range is suspicious for hypoglycemia?
<4.0 mmol/L.
161
What BGL range is suspicious for hyperglycemia and needs ALS support?
>11.0 mmol/L — especially if symptoms of DKA or HHS are present.
