Confusion Plan

Assessment & Plan Elements, Geriatrics
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Acute management:
[checkbox name="acutetx" value="Intravenous Access|Oxygen Delivery|C-Spine immobilization (for suspected trauma)|Dextrose (Suspected Hypoglycemia, bedside Glucometer first if possible): Adult: 50 ml of D50 IV, Child: 4 ml|kg D25 (0.5-1.0 g/kg) IV|Flumazenil (Suspected Benzo Overdose): Flumazenil 0.2 - 1.0 mg IV|Naloxone (Suspected Narcotic Overdose): Adult: 2-4 mg IV, Child: 0.1 mg/kg IV|Thiamine (Suspected Wernicke's Encephalopathy): Adult: 100 mg IV, Child: 10-25 mg IV|Monitoring and redirection as needed|Other"]
[conditional field="acutetx" condition="(acutetx).is('Other')"][textarea default="detail 'Other' interventions"][/conditional]
Evaluation:
Vital signs including pulse oximetry significant for [text]
Blood pressure: [checkbox value="Systolic Blood Pressure <90: Brain Lesion unlikely|Systolic Blood Pressure >170: Brain Lesion likely"]
Level of consciousness [select value="Alert|Verbal Stimulus Response|Painful Stimulus Response|Unresponsive"]

Delirium elements [comment memo="needs to have all 4. consciousness: 'clarity of awareness about the environment.' cognition: 'memory, orientation, language.'"]
[checkbox value="Disturbance of consciousness with reduced ability to focus/sustain/shift attention.|A change in cognition or development of a perceptual disturbance not better accounted for by a preexisting/established/evolving dementia.|The disturbance develops over a short period of time (usually hours to days) and tends to fluctuate during the course of a day.|Evidence that the disturbance is caused by direct physiologic consequences of a general medical condition."]

Diagnostic evaluation: [checkbox value="point of care glucose|urinalysis|CBC|Chemistry panel|Liver Enzymes|Serum Osmolarity (calculated: = 2*Na+ + Glucose/18 + BUN/2.8 where Glucose and BUN are measured in mg/dL.)|Serum Calcium|Serum Magnesium|Urine Tox Screen|Directed drug levels|Arterial Blood Gas|Rapid Plasmin Reagin (RPR)|Thyroid Stimulating Hormone (TSH)|Electrocardiogram (EKG) and/or cardiac monitor|Head CT|Lumbar Puncture|C-Spine films (if trauma suspected)|Chest XRay|HIV Test|Heavy metal screen|Vitamin B12 Level|Serum Folate Level"]
Acute management:


Evaluation:
Vital signs including pulse oximetry significant for
Blood pressure:
Level of consciousness

Delirium elements needs to have all 4. consciousness: 'clarity of awareness about the environment.' cognition: 'memory, orientation, language.'


Diagnostic evaluation:
Result - Copy and paste this output:

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    Mark Morgan MD
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    Acute management: Evaluation: Vital signs including pulse oximetry significant for Blood pressure: Level of consciousness Delirium elements Diagnostic
    [See the full post at: Confusion Plan]

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