Detection of Altered Mental State

Mr Thomas arrived at the hospital overnight, was triaged in the ED and immediately admitted to the respiratory ward. IV ceftriaxone and merepenum were continued.

Admission staff noted that Mr Thomas appeared agitated and restless.  He also had reduced attention span and trouble following conversations. Mr Thomas was repeatedly asking where he was. His speech was slow and at times, incoherent.

Since admission, he has been frequently pulling out the intravenous line.

Before you assess Mr Thomas, read the patient’s transfer letter from the remote area nurse.