Altered Mental Status

Question 1

The mneumonic He Stops for Tips and Vowels is used for possible causes of AMS. What does it stand for?

Answer 1

H- HTN/Hepatic
E- electrolytes… Na or Ca

S- stroke
T- Trauma
O- opioids
P- psych
S- seizure

T- temp
I- infection
P- porphyria
S- sepsis

A- acidosis
E- endocrine (glucose, thyroid, addison's)
I- intoxication/ wIthdrawal
O- oxygen and carbon dioxide levels 
U- uremia

Question 2

When a patient has AMS, what should you order to help determine what the cause is?

Answer 2

• CBC
• BMP
• LFTs
• Urine tox
• TSH
• ABG

*if the cause may be a stroke, a CT scan would be a great idea. *may not need a CT scan for everyone with AMS