pediatric altered mental status

26 Jul

Article by Muniz AE:

Question: Pediatric patients level of consciousness can be difficult to detect and their etiologies differ from adults. What are the most common causes of AMS in pediatrics?

Methods: Prospective epidemological study of 145 children at VCU with AMS from 6/99 -12/03

Results: There were 31 different diagnoses:

  • overdoses 18 (12.4%)
  • ethanol intoxication 15 (10.3%)
  • seizures 13 (8.9%)
  • dehydration 13 (8.9%)
  • medication side effects 7 (4.8%)
  • hypoglycemia 6 (4.1%)
  • traumatic brain injury 6 (4.1%)
  • pyelonephritis 3 (2%),
  • viral meningitis 2 (1.3%),
  • CO poisoning 2 (1.3%)
  • viral infection 2 (1.3%)
  • pneumonia 2 (1.3%)

Teaching point: Differential is broad, obviously. Overdoses and side effects from medications are high on the differential for the altered peds patient.

Submitted by W. Rushton.

Reference(s): Muniz AE “Altered Mental Status Evaluation in Children Presenting to an Emergency Department” Annals of Emergency Medicine Vol. 46, Issue 3, Supplement, Page 72; picture

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