Pediatric
Altered Mental Status
General Adult Assessment
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BG <60 mg/dl
Blood glucose testing
BG >60 mg/dl
BG <40 mg/dl in
newborn
Vascular Access
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ORAL GLUCOSE
if patient is
protecting airway
Cardiac monitor
12-lead ECG
D10
, 5 ml/kg IV
max single dose 25 gm
Consider
NS
20 ml/kg IV;
may repeat up to 60 ml/kg;
if BG >250, then 10 ml/kg
bolus
GLUCAGON
0.5 mg IM (<20 kg);
1.0 mg IM (>20 kg) for no IV access
Improved mental
status?
Consider the
following:
No
No
Yes
Other treatment protocols
as indicated
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Evidence of a seizure
of post-ictal state?
Signs of hypoperfusion?
Signs of trauma
or head injury?
Seizure
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Shock
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General Trauma
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If unresponsive, with
respiratory depression &
suspected narcotic overdose
NALOXONE
0.1 mg/kg IN/IM/IV;
may repeat if
patient slow to respond;
titrate to effect;
max single dose 2.0 mg
total dose 10mg
Overdose/Poisoning
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⚠️ Treat hypoglycemia
and suspected
narcotic overdose
begore using
advanced airways!!
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