A comprehensive clinical examination is the basis for selecting further diagnostic steps. As a general rule, an emergency physical examination must be performed first in persons who have become unconscious: Glasgow Coma Scale (GCS) – scale for estimating impaired consciousness. Criterion Score Eye opening spontaneous 4 on request 3 on pain stimulus 2 no reaction … Acute Confusion: Examination
1st order laboratory parameters – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood), sediment, if necessary urine culture (pathogen detection and resistogram, that is, testing suitable antibiotics for sensitivity / resistance). Electrolytes – calcium, chloride, potassium, magnesium, … Acute Confusion: Test and Diagnosis
Optional medical device diagnostics – depending on the results of the history, physical examination, laboratory diagnostics, and obligatory medical device diagnostics – for differential diagnostic workup Electrocardiography (ECG) X-ray of the thorax (X-ray thorax/chest). Computed tomography of the skull (cranial CT; cCT) or magnetic resonance imaging of the skull (cranial MRI; cMRI) – if a … Acute Confusion: Diagnostic Tests
The following symptoms and complaints may occur together with acute confusion: Leading symptom Acute confusion Associated symptoms Fever General feeling of illness Cyanosis – bluish discoloration of the skin/mucous membrane due to lack of oxygen. Tachypnea – accelerated breathing. Ketone odor of exhaled air Neurological symptomatology such as paralysis symptoms Notes Always measure glucose (blood … Acute Confusion: Symptoms, Complaints, Signs
Medical history (history of illness) represents an important component in the diagnosis of acute confusion. Family history What is the general health of your family members? Are there any diseases in your family that are common? Are there any hereditary diseases in your family? Social history What is your profession? Are you exposed to harmful … Acute Confusion: Medical History
Respiratory System (J00-J99) Chronic obstructive pulmonary disease (COPD) – progressive (progressive) airway obstruction (narrowing) that is not fully reversible (reversible). Pneumonia (inflammation of the lungs) Endocrine, nutritional and metabolic diseases (E00-E90). Dehydration (lack of fluids) [esp. in old age]. Diabetic ketoacidosis – severe metabolic derailment (ketoacidosis) in the absence of insulin) – mainly in diabetes … Acute Confusion: Or something else? Differential Diagnosis
