Regional Emergency Medical Advisory Committee of New York City
Prehospital Basic Life Support Protocols
Copyright January 1996 (8/96)

411 ALTERED MENTAL STATUS

NOTE:EMOTIONALLY DISTURBED PATIENTS MUST BE PRESUMED TO HAVE AN UNDERLYING MEDICAL OR TRAUMATIC CONDITION CAUSING ALTERED MENTAL STAUS. ASSES SUCH PATIENTS FOR AN UNDERLYING MEDICAL OR TRAUMATIC CONDITION CAUSING AN ALTERED MENTAL STATUS AND TREAT AS NECESSARY.

Assess the situation for potential or actual danger and establish a safe zone, if necessary.

NOTE:ALL SUICIDAL OR VIOLENT THREATS OR GESTURES MUST BE TAKEN SERIOUSLY. THESE PATIENTS SHOULD BE IN POLICE CUSTODY IF THEY POSE A DANGER TO THEMSELVES AND/OR OTHERS.

If an underlying medical or traumatic condition causing an altered mental status is not apparent; the patient is fully conscious, alert, and able to communicate; and an emotional disturbance is suspected, see Protocol #430.

Monitor the airway.

Observe spinal injury precautions, if appropriate. (See Protocol #421.)

Administer oxygen.

Request Advanced Life Support assistance, if appropriate.

If the patient is conscious, has a gag reflex, and is able to drink without assistance, provide a glucose solution, fruit juice, or non-diet soda by mouth.

Do NOT give oral solutions to unconscious patients.

Do NOT give oral solutions to patients with head injuries.

Transport.

Assess and monitor the Glasgow Coma score. (See Appendix E.)

Do NOT delay transport.

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