title: Clear the fog: the challenges of altered mental status in children.
abstract: EMS is dispatched to a residence for an "unresponsive child." On arrival, a frantic mother is waiting at the door and directs the crew to the living room. EMS providers find an 8-year-old male who's only responsive to deep pain. While one paramedic assesses the patient, their partner obtains a history from the mother. The mother states her child was complaining of a headache for the past week, and says it worsened earlier today. He's an otherwise healthy child. A full primary survey reveals that airway breathing and circulation (ABCs) are intact. The patient's vital signs are a heart rate of 60, respiratory rate of 8, blood pressure of 160/120 and oxygen saturation of 90%. An IV is established, and a glucose check is administered, revealing a blood sugar of 95. The patient will only respond to deep, sternal rub.
authors.affiliation: Monroe Carrel Jr. Children's Hospital, Vanderbilt. mark.meredith@vanderbilt.edu
authors.forename: Mark
authors.initials: M
authors.lastname: Meredith
authors.forename: Lee
authors.initials: L
authors.lastname: Blair
authors.forename: Eric
authors.initials: E
authors.lastname: Clauss
mesh_terms: D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D004632:Emergency Medical Services / Q000458:organization & administration*; D006801:Humans; D007223:Infant; D001523:Mental Disorders / Q000175:diagnosis* / Q000209:etiology*; D010808:Physical Examination