The American Academy of Neurology (AAN) has updated their guidelines for managing altered mental status (AMS) patients coming into the emergency department.
The American Academy of Neurology (AAN) has updated their guidelines for managing altered mental status (AMS) patients coming into the emergency department.
And would alter the algorithm a bit; it needs way more useless tests like checking a B12 level.
proudest resid. moment was stroke alert w neg alcohol, serum and utox, with +glycol panel :).
Psych is on the algorithm..
Hilarious !Takes my stress away at the end of the day !
Or request psych bed on initial arrival- prior to any foolish UA.
way too simplified, cookie-cutter way but helps some who need guidance
So good!
Pretty much…
Love the fact that the neurological service is never mentioned. Stroke dodging bastards. Surprised the protocol left off the big letters at the bottom: IF ALL ELSE FAILS CALL THE FP, MURMUR SOMETHING UNINTELLIGIBLE AND GIVE A ROOM NUMBER. IF THE FP DARES TO SPEAK SCREAM “YOU’RE THE PRIMARY” IN AN AGITATED TONE, SET OFF A RANDOM ALARM IN THE ER AND PUT THE PHONE DOWN ON THE DESK. AS YOUR VOICE FADES INTO THE DISTANCE HAVE A RANDOM NURSE HANG IT UP. PRACTICE THIS DRILL WITH SEVERAL NURSES. Bonus points if the FP service never figures out what your admitting diagnosis was. Double bonus points if pt gets to the floor and the FP name is on the chart before the labs come back. Triple bonus points if all of the above is true AND the patient has no IV access. Sweepstakes prize if the pt is non communicative and was on the medicine service last week and was discharged home with an elderly spouse prior to the 3 days needed for SNF placement… I can play this game all night.
Damn it, they’re on to us: Leon Leon Grant, Jitesh Kar, Proleta Datta, Michelle Christie, Keely Fitzgerald
Alex Josiah Dunn yes, yes we did
Ok we have similar decision tree jokes in tech so now am aware of how not funny they are to layman
Hummmm John Dempster can you translate?
Truth in satire!
It all looks good to me!
Ha!
I can always find the UTI. The problem is that I don’t go home, just off to the next brain.
You forgot “review chart for ED staff and tell them reason for identical presentation the pt had last month” and “beg for tox screen”
Brady Nutzman
Blame the Seroquel and trazodone. That way Narcan shouldn’t work.
Somewhere before “probably a stroke”, there should be discontinue all anticholinergic drugs, go home and have a scotch.
Brandi Anderson
Let’s include statistics in the manual here…AMS is about 5% of the time primary neurologic? Thanks for the consult. Let’s not check a sugar, get the 14th head CT this year, and call a consult. Ha.
Haley did we write this?
I didn’t see “yell at the internist” on the algorithm
Surprisingly accurate…
Mohammad, Dustin, Nitish: LOL!
Yup. I don’t need a practice parameter for that. It’s just good medicine!
How about the dreaded, “We are just a consult service, we don’t admit.” Then in the AM when they still haven’t seen the patient, “I didn’t realize you wanted a consult.”
Matthew Thompson
genius
Hahahhahahahahhahaahahahhauahahauauauuauauaauauuauauwuwuwuwuwwuwuuwu!
They forgot a step off of “probably a stroke.” –> Has one of the following: diabetes, pneumonia, CAD, COPD, polypharmacy, or finger pain –> Turf to medicine, act as a neuro consult.
I’m honored they have a flow chart just for me.
Lol!!
Michelle – do you want me to laminate these new neuro guidelines and put this in each of the protocol notebooks?
They forgot to add “patient faking stroke symptoms” call Psych!
Mark Omar Waheed
David Weisman Brad Klein
Hahaha oh my. This is amazing.
Craig Costello
always check the urine for drugs… cc Matthew Josh Akhila Katherine Shon David
Marc Wasserman, are these all of your diagnosis secrets??
Terri McDaniel Todd
Christian Basque George Rucco
Lots of punting going on here.
But you’ve missed the step where you blame the narcotics, even when the Narcan doesn’t change the patient’s status…
That’s pretty spot on.
Probably a stroke, face palm. My life every shift
This is scary, because it could work.