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C3 - Altered Mental Status - Part 2

Stuart Swadron, MD FAAEM, Mel Herbert, MD MBBS FAAEM, and Mizuho Spangler, DO
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57:02
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No me gusta!

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C3 - Altered Mental Status - Part 2 - Written Summary 265 KB - PDF

Stuart and Mizuho continue their discussion about AMS, and discuss less common but interesting causes of AMS, including clinical findings, workup and management of these various diagnoses.

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Alex I. -

Just a clarification for anticholinergic toxicity. The BLIND as a BAT is due to cycloplegia (ciliary muscle paralysis with loss of accommodation) associated with mydriasis (NOT MIOSIS). So look for dilated pupils!

Mel H. -

Yes you are correct - they get dilated pupils, we are setting about correcting that error! Thanks!

Erin M. -

Love this! A few things I noticed...

Glucose - in the first part, it says to give an amp of d50 if < 80. Further down, it says < 70. I *think* (I could be wrong, I'm hearing impaired) in today's part it said <60. Which one is it?

The hypertensive encephalopathy was left off the written summary

Thanks for doing all this! It really is helpful!

Xander Merboo -

Wait, what?
Did I overhear someone talking about hanging a banana bag for an alcoholic? Why (pray tell) would one do that?

"Conclusions: in our ED, patients with acute ethanol intoxication do not have B12 or folate deficiencies ... Widespread administration of multivitamins is unwarranted by these findings"

Vitamin deficiencies in acutely intoxicated patients in the ED
Siu Fai Li MDJulie Jacob MDJimmy Feng MDMiriam Kulkarni MD

The American Journal of Emergency Medicine
September 2008, Vol.26(7):792–795, doi:10.1016/j.ajem.2007.10.003

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C3 - Altered Mental Status - Part 2 Full episode audio for MD edition 57:02 min - 48 MB - M4AC3 - Altered Mental Status - Part 2 C3: Continuous Core Content 57:02 min - 78 MB - MP3C3- Altered Mental Status - Part 2 - MP3 78 MB - MP3C3 - Altered Mental Status - Part 2 - Written Summary 265 KB - PDF