Decreased LOC & AMS

Altered Mental Status 



“Disorders of consciousness may be divided into processes that affect either arousal or content of consciousness, or combination of both.

  • Arousal behaviours include wakefulness and basic alerting.
  • Content of consciousness include self-awareness, language, reasoning, spatial relationship integration, emotions, and the myriad complex integration processes that make us human.
  • Mental status is the clinical state of emotional and intellectual functioning of the individual.”1



  • Delirium, acute confusional state, acute cognitive impairment, acute encephalopathy, altered mental status, and other synonyms all refer to a transient disorder with impairment of attention and cognition. Alerting functions are working, perhaps over working. The patient has difficulty focusing, shifting, or sustaining attention. Confusion may fluctuate.”1
  • “The acute onset of attention deficit and cognitive abnormalities fluctuating in severity throughout the day and worsening at night is virtually diagnostic of delirium.”1



  • “Dementia implies a loss of mental capacity. Psychosocial level and cognitive abilities deteriorate and behavioural problems about. The typical course of dementia is slow with insidious symptom onset.
  • The abrupt onset of symptoms are rapidly progressive symptom should probably search for other diagnoses.”1
  • Elderly patients with altered mental status.



  • “Coma is a state of reduced alertness and responsiveness from which the patient cannot be aroused.
  • In the approach to the comatose patient, stabilization, diagnosis, and treatment actions are perform simultaneously.”1


Click HERE for a list of all mentioned FOAM resources.


  1. Huff, J., Chapter 168, “Altered Mental Status and Coma”. Tintinalli’s Emergency Medicine – A Comprehensive Study Guide. J Tintinalli. 8th ed. McGraw-Hill Education, 2016.


Prepared by Alex Mungham PGY1 FM – University of Ottawa