More pearls from our fantastic morning report series.
Core EM - Emergency Medicine Podcast Episode 134.0 – Morning Report Pearls III
Feb 26, 2018
This installment dives into altered mental status, stressing the importance of categorizing potential causes. There’s a focus on children, highlighting the rarity of primary psychosis and the need to consider toxic ingestions. Discussing hyperleukocytosis in patients with acute lymphoblastic leukemia, it emphasizes timely intervention with hematology. Finally, the urgency of managing severe hyponatremia is explored, detailing treatment protocols to avoid complications. A wealth of practical insights for emergency medicine practitioners awaits!
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5 Categories for Pediatric AMS
- Altered mental status in kids can be categorized using five broad diagnostic categories similar to adults.
- Primary psychiatric causes are rare in kids and should only be diagnosed after thorough organic exclusion.
Rule Out Organic Causes First
- Always consider rare causes and toxic ingestions in kids with altered mental status.
- Conduct thorough examinations to rule out organic causes before labeling psychiatric disorders.
Misdiagnosed Psychosis in Child
- A nine-year-old girl with command hallucinations diagnosed with schizophrenia was later found to have HSV encephalitis and temporal lobe epilepsy.
- This case highlights the importance of reconsidering rare diagnoses in pediatric AMS.