1/5
Prompted by a #Morningreport a while back.
3 rapid response situations for AMS.
Could an exam of the pupils help get to the bottom of the situation ?
(in addition to checking glucose etc)
A brief list of causes of miosis and mydriasis below:
#medtwitter #MedStudentTwitter
Prompted by a #Morningreport a while back.
3 rapid response situations for AMS.
Could an exam of the pupils help get to the bottom of the situation ?
(in addition to checking glucose etc)
A brief list of causes of miosis and mydriasis below:
#medtwitter #MedStudentTwitter
2/5
Case 1- Acute AMS for a patient with a newly placed fentanyl patch
Pupils- B/l Miosis remember the 4 P's
Case 1- Acute AMS for a patient with a newly placed fentanyl patch
Pupils- B/l Miosis remember the 4 P's
3/5
Case 2- Subacute AMS for a patient with
+ fever, shakes, tachycardia, diaphoresis on zyprexa, zoloft, linezolid, tramadol & zofran.
Pupils: Bilateral Mydriasis
Dx- Serotonin syndrome
Case 2- Subacute AMS for a patient with
+ fever, shakes, tachycardia, diaphoresis on zyprexa, zoloft, linezolid, tramadol & zofran.
Pupils: Bilateral Mydriasis
Dx- Serotonin syndrome
4/5
Case 3- Acute AMS with a recent opoid analgesic dose.
Pupils: Single fixed dilated pupil
Initial thought for AMS--> Opoid dose
Pupillary exam--> Fixed dilated pupil
--> consider ICH/HTN
Head CT-> Large ICH/Midline shift
Case 3- Acute AMS with a recent opoid analgesic dose.
Pupils: Single fixed dilated pupil
Initial thought for AMS--> Opoid dose
Pupillary exam--> Fixed dilated pupil
--> consider ICH/HTN
Head CT-> Large ICH/Midline shift
5/5
In the rapid evaluation of a comatose pt,
incorporating the examination of the pupils can help to narrow your focus.
Be mindful that there can be causes of abnormal pupils that are not due to an ominous etiology. (can check an ID or photos of the pt to confirm).
In the rapid evaluation of a comatose pt,
incorporating the examination of the pupils can help to narrow your focus.
Be mindful that there can be causes of abnormal pupils that are not due to an ominous etiology. (can check an ID or photos of the pt to confirm).
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