INITIAL MANAGEMENT OF THE PATIENT WITH ALTERED MENTAL STATUS

Primary care physicians may encounter patients with altered mental sta tus or neurologic deficit. Because the differential diagnosis for alte red mental status includes conditions with significant morbidity and m ortality care of these patients must be rapid and thorough. The resour ces required to ensure and maintain cardiopulmonary stabilization and to perform the initial workup are often unavailable in the primary car e office setting. Therefore, these patients often require immediate re ferral to an emergency department. Proper evaluation and initial manag ement include evaluation of metabolic factors, assessment for toxic in gestions and a thorough neurologic assessment.