the acutely confused patient

see also:

• the comatose patient
• delirium

• see hypoxia
• pneumonia, pulmonary embolism (PE), acute pulmonary oedema (APO)
• pneumothorax
• chest injury
• respiratory depression
  • toxicology
  • myasthenia gravis
  • muscular dystrophy
  • painful chest wall trauma
  • head injury

• intoxication or withdrawal
  • ethanol intoxication/poisoning
  • gamma hydroxybutyrate (GHB)
  • amphetamines and related psychostimulant substances
  • opiates and opioids
  • cocaine
• adverse effects (esp. children and elderly)
  • anti-muscarinic anticholinergic agents
  • sedatives, hypnotics and anxiolytics
  • opiates and opioids
  • anticonvulsants
  • antiparkinsonian
  • phenothiazines
  • neuroleptic malignant syndrome (NMS)
  • serotonin syndrome
• poisons
  • ethylene glycol, methanol
  • carbon monoxide
  • cyanide
  • hydrogen sulphide
  • plants eg. Jimson weed, salvia

• head injury
• seizures / post-ictal state
• stroke (CVA)
• subarachnoid haemorrhage (SAH)
• meningitis / encephalitis
• space occupying lesion - tumour, abscess, haematoma
• hypertensive encephalopathy
• systemic lupus erythematosus (SLE)

• acute kidney injury (AKI) / acute renal failure (ARF)
• hepatic encephalopathy
• hyponatraemia, hypernatraemia, hypercalcaemia
• vitamin deficiency eg. Wernicke's encephalopathy
• acute intermittent porphyria
• hypoglycaemia
• heat illness and heat stroke
• fever-related delirium
• sepsis / septicaemia
• hypothermia

• diabetic ketoacidosis (DKA)
• thyrotoxicosis
• hypothyroidism
• Cushing syndrome
• corticosteroids
• Addisonian crisis