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Acute Altered Mental Status in Elderly Patients

Acute Altered Mental Status in Elderly Patients. Taken from EMSWORLD.com February 2013. Acute Altered Mental Status in Elderly Patients. Can be challenging to determine the cause. Acute Altered Mental Status in Elderly Patients. Subtle changes often go unrecognized.

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Acute Altered Mental Status in Elderly Patients

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  1. Acute Altered Mental Status in Elderly Patients Taken from EMSWORLD.com February 2013

  2. Acute Altered Mental Status in Elderly Patients • Can be challenging to determine the cause

  3. Acute Altered Mental Status in Elderly Patients • Subtle changes often go unrecognized

  4. Acute Altered Mental Status in Elderly Patients • Only 30% of patients with delerium are identified

  5. Acute Altered Mental Status in Elderly Patients • Elderly are those 65 and older and make up 10% of the population

  6. Acute Altered Mental Status in Elderly Patients • Altered mental status is present in 10% of all elderly patients who present to the emergency department

  7. Acute Altered Mental Status in Elderly Patients • Many of these patients will present via EMS

  8. Acute Altered Mental Status in Elderly Patients • One in nine of these patients ultimately die during their hospital stay

  9. Acute Altered Mental Status in Elderly Patients • Delerium represents a serious underlying condition and is marked by an acute change in cognition

  10. Acute Altered Mental Status in Elderly Patients • Delerium is defined as a disturbance of consciousness and change in cognition that develops over a short period of time

  11. Acute Altered Mental Status in Elderly Patients • Delerium is not natural and not associated with diseases such as dementia and Alzheimer's

  12. Acute Altered Mental Status in Elderly Patients • Delerium is a hyper or hypoactive alteration in brain function and affects behavior, memory, actions, and attitudes.

  13. Acute Altered Mental Status in Elderly Patients • Delerium may be the only symptom of a serious underlying medical condition

  14. Acute Altered Mental Status in Elderly Patients • Delerium and Dementia are NOT the same

  15. Acute Altered Mental Status in Elderly Patients • Delerium is not the same as a gradual mental status change

  16. Acute Altered Mental Status in Elderly Patients • Things to look for in Delerium • An acute onset of the condition • Patient’s inattention • Disorientated thinking • Altered level of consciousness

  17. Acute Altered Mental Status in Elderly Patients • Dementia is generally thought of as a single disease caused by decreased brain size and function that becomes a permanent cognitive impairment worse than would be expected for the patient’s age.

  18. Acute Altered Mental Status in Elderly Patients • Dementia is NOT reversible

  19. Acute Altered Mental Status in Elderly Patients • Sepsis is a common cause of mental status change • The entire body has an increased oxygen demand that can lead to hypoxia • Toxins are released into the blood stream that can impair normal brain function • Metabolic acidosis occurs which interrupts normal brain function

  20. Acute Altered Mental Status in Elderly Patients • Infection sources are not always obvious • UTI’s are one of the most common causes of delerium in patients over 50 • Anytime an elderly patient appears toxic and has a history of diabetes or immunocompromised, consider a UTI

  21. Acute Altered Mental Status in Elderly Patients • Avoid Ringers Lactate • It contains lactate which may make the situation worse if they are experiencing lactic acidosis

  22. Acute Altered Mental Status in Elderly Patients • It is important to communicate sepsis suspicion to the physician • For each hour that passes with no intervention, the patient’s mortality rate increases by 7.6%

  23. Acute Altered Mental Status in Elderly Patients • Remember: • Delerium may signal a life-threatening underlying medical condition • Delerium is not associated with dementia and is not a normal part of the aging process • Delerium is often subtle and easy to miss • Use family and friends to help understand the patient’s behavior

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