The Call for Altered Mental Status: A Challenge for First Responders

摘要

MANY MEDICAL CALLS ARE dispatched as "altered mental status," and they are some of responders' more challenging calls. Patients who have altered mental statuses often are exhibiting delirium. Delirium is defined as the inability to sustain, focus, and shift attention that develops over a short period of time.1 What this means in practical terms is that patients have an altered awareness of the environment and have difficulty with concentration. If you have ever had a fever and been confused, you have experienced delirium. Patients have described this experience as "being in a fog" where they cannot keep their thoughts straight and logical. It is important to note that delirium is not a psychiatric condition; it is a sign of medical illness in a patient. It is a sign that the patient is ill and the medical condition is affecting the patient's brain. Anyone is susceptible to delirium. However, patients with underlying cognitive disorders are at a higher risk of developing delirium. This includes patients with dementia, Parkinson's disease, developmental delay, traumatic brain injury, history of illicit drug and alcohol abuse, and elderly patients (Table 1).