Altered Mental Status / Syncope
General Adult Assessment
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BG <60 mg/dl
Blood glucose testing
BG >60 mg/dl
Vascular Access
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ORAL GLUCOSE
if patient
is protecting airway
No
Cardiac monitor
12-lead ECG
D10
, 25g IV;
(250mL of 10% solution);
may repeat x 1 in 5 min
Consider
NS
500ml IV;
may repeat up to 2000 ml
GLUCAGON
1.0mg IM for no IV access
Improved mental
status
Consider the
following:
Yes
Signs of
stroke?
Stroke
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Other treatment protocols as
indicated
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Signs of
hypoperfusion?
Shock
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Signs of seizure
or post-ictal state?
Seizure
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Signs of trauma
or head injury?
General Truama
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Cardiac causes/
known disease?
Appropriate cardiac
protocol
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Unresponsive with
respiratory depression &
suspected narcotic overdose
NALOXONE
0.4 – 2.0 mg IN/IM/IV;
may repeat 2.0 mg IN/IM/IV
if patient slow to respond;
titrate to effect;
max dose 10 mg
Overdose/Poisoning
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