Alteraçãodo estado mental

INTRODUCTION
Altered mental status is a common chief complaint among older patients in the emergency department (ED). Despite the frequency of this complaint, the term
“altered mental status” is vague and has several synonyms such as confusion, not acting right, altered behavior, generalized weakness, lethargy, agitation, psychosis, disorientation, inappropriate behavior, inattention, and hallucination.1 Such lack of standardized terminology not only hinders the assessment and appropriate management of patients with altered mental status but also the advancement of knowledge through research.
Jin H. Han is supported by a grant from the National Institute on Aging, K23AG032355. a Department of Emergency Medicine, Center for Quality Aging, Vanderbilt University School of Medicine, 703 Oxford House, Nashville, TN 37232-4700, USA; b Department of Emergency
Medicine, Emergency Medicine Research Center, Summa Akron City Hospital, Northeastern
Ohio Medical University, 525 East Market Street, Akron, OH 44309, USA
* Corresponding author.
E-mail address: [e-mail]
KEYWORDS

Delirium
Coma
Stupor
Emergency department
Epidemiology
Diagnosis

Management
KEY POINTS

Altered mental status is a common chief complaint among older patients in the emergency department (ED).

Patients with acute changes in mental status are likely to have delirium, stupor, and coma, and these changes are commonly precipitated by an underlying medical illness that can be potentially life-threatening.

Although stupor and coma are easily identifiable, the clinical presentation of delirium can be subtle and is often missed without actively screening for it.

The ED management of patients with altered mental status should initially be focused on stabilizing the patient (airway, breathing, circulation) while searching for the underlying etiology. Clin Geriatr Med 29 (2013) 101–136
http://dx.doi.org/10.1016/j.cger.2012.09.005