On a recent PHEC programme I found I was spending a lot of time focussing on a traumatic head injury as the reason for a patient being either unconscious or having an altered or lowered level of consciousnessness.
However it is important to remember that there are numerous potential causes that could lead to a lowered level of consciousness
A handy mnemonic to assist in remembering these causes is AEIOUTIPS
- has this person recently been drinking ? A very common reason for an altered level of conscoiusness! Can you smell alcohol on their breath?
- could this person have had a seizure - either from epilepsy or another cause?
- could this patient be a diabetic having a hypoglycemic episode? Look for a medic alert bracelet and any of the following: a blood glucose metre, insulin, sweets or a glycogen pen.
- is it possible that this person has had some sort of overdose? Look for medication bottles at the scene and evidence of drug use - either prescription drugs, opiates or hallicinagens.
Uremia or underdose
- Does this person have a history of renal failure/disease. Could they require and have missed some sort of regular medication?
- Is it possible that this person has been assulted and had a blow to the head or are they suffering from a severe bleed?
- Has this person been ill recently? Feel their skin for signs of a high temperature. Children and the elderly are particularly at risk here.
Psychiatric or Poisoning
- Does the person have a history of catatonic episodes or depression? For poisoning look for obvious signs - like bottles etc and for less obvious like CO poisoning.
Stroke or Shock
- An eschemic stroke or other event (like a tumor) could put pressure on the brain. Look for muscular weakness on one side (of their face especially) or uneven, sluggish pupils. For shock remember to think not only of low blood volume - caused by bleeds (internal or external) but also think of the likelihood of cardiogenic and anaphylaxis shock
Thanks so much to the valuable website where we sourced this info - the EMT Spot