In the altered mental status protocol, which step follows the primary assessment?

In the altered mental status protocol, which step follows the primary assessment?

• A. History, physical, vitals
• B. Perform glucometry
• C. Transport
• D. Treat for shock

Answer: (A)

After the primary assessment has ensured the airway, breathing, and circulation are stabilized, the next focus is a secondary assessment to gather information that explains the altered mental status and guides treatment. This means collecting a concise history from the patient or bystanders, performing a focused physical examination (with emphasis on the neurological status), and recording vital signs. The history reveals potential causes such as hypoglycemia, stroke, infection, drug effects, or metabolic problems, while the physical exam shows current deficits and clues from the neurological exam, trauma, signs of intoxication, or infection. Vital signs establish the patient’s current stability and help detect trends that may require immediate action or influence transport decisions. Glucometry is important and often done early as part of the broader evaluation, but the information gathered from history, physical, and vitals is the primary next step in guiding care after the initial survey.

After the primary assessment has ensured the airway, breathing, and circulation are stabilized, the next focus is a secondary assessment to gather information that explains the altered mental status and guides treatment. This means collecting a concise history from the patient or bystanders, performing a focused physical examination (with emphasis on the neurological status), and recording vital signs. The history reveals potential causes such as hypoglycemia, stroke, infection, drug effects, or metabolic problems, while the physical exam shows current deficits and clues from the neurological exam, trauma, signs of intoxication, or infection. Vital signs establish the patient’s current stability and help detect trends that may require immediate action or influence transport decisions. Glucometry is important and often done early as part of the broader evaluation, but the information gathered from history, physical, and vitals is the primary next step in guiding care after the initial survey.