UNCONTROLLED WHEN PRINTED

History Gathering:

  • Was the event witnessed?
  • How did the patient fall e.g. hit head?
  • What was the patient doing prior to the collapse e.g. climbed stairs, gave blood?
  • Onset.
  • Duration.
  • Any seizure activity?
  • Medications.
  • Diseases.     
  • Previous episodes.

 

AEIOU-TIPS is a mnemonic acronym used to recall the possible causes for altered mental status:
 Components of AcroynmExamples
AAlcohol and/or abuse of substances.
Acidosis
  • Alcohol or drug intoxication
  • Diabetic ketoacidosis
  • Hypoventilation due to COPD
  • Asthmatic airway obstruction or neuromuscular disease
EEnvironmental
Epilepsy
Electrolytes
Encephalopathy
Endocrine disease
  • Hypothermia; hyperthermia
  • Epileptic seizure (or seizure for any other reason) 
  • Hyponatremia / hypernatremia; hypocalcaemia / hypercalcemia
  • Wernicke's encephalopathy
  • Chronic traumatic encephalopathy (CTE) 
  • Adrenal insufficiency
  • Thyroid disease
IInfection
  • Encephalitis
  • Meningitis
  • Meningoencephalitis
  • Sepsis
OOverdose
Oxygen deficiency
  • Prescription or non-prescription drug overdose
  • Hypoxia due to pulmonary oedema or tension pneumothorax
  • Hypoxic brain injury due to cardiac arrest. 
UUnder dose
Uraemia
  • Insufficient dose of prescription medications
  • Excess urea in the blood due to kidney failure
  • Congestive heart failure
  • Urinary obstruction
TTrauma
Tumour
  • Concussion
  • Traumatic brain injury
  • Increased intracranial pressure due to epidural haemorrhage
  • Brain tumour or metastasis to the brain
  • Paraneoplastic syndrome
IInsulin
  • Hypoglycaemia
  • Hyperosmolar hyperglycaemic state
PPsychogenic
Poisons
  • Psychosis
  • Pseudo seizure; conversion disorder
  • Carbon monoxide poisoning
  • Heavy metal poisoning
SStroke
Shock
  • Haemorrhagic stroke due to arteriovenous malformation (AVM)
  • Neurogenic shock due to spinal cord injury
  • Cardiogenic shock due to myocardial infarction

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