Altered mental status (peds)
This page is for pediatric altered mental status. See altered mental status for the adult page.
- Both cerebral cortices must be affected to cause altered mental status
- Glucose, CBC, chem, UA, CSF, LFT, utox, VBG, BAL, thyroid, Calcium (ionized)
- Immobilize cervical spine for suspected trauma
- Fluid resuscitation 20 mL/kg x3 as needed; start pressors thereafter
- Antibiotics for sepsis or meningitis (consider viral it patient is toxic)
- Naloxone for opiate or clonidine overdose (0.01-0.1mg/kg IV q2 min)
- Glucose for hypoglycemia (2 mL/kg of 25% dextrose)
- Avoid sodium bicarbonate for metabolic acidosis unless pH <7.0
- Control seizures
- Prevent hypothermia, treat hyperthermia
- Source APLS page 182, 5th ed.