Mnemonic AEIOU Tips for Altered Mental Status

First responders are taught AEIOU TIPS as a mnemonic device to handle Altered Mental State (AMS) patients.

As a medical professional in such emergencies, one must typically follow ABC:

• ensure open airways
• support breathing
• perform CPR.

Additionally, when symptoms of AMS are observed, the AEIOU TIPS assessment can be used to analyze the patient’s condition and help narrow down possible treatments. This method is an additional tool for first responders to provide lifesaving aid.

Understanding what these seven letters mean could help make the difference between life and death if you find yourself in a first-aid situation. Read on to learn more about each step of this critical lifesaving procedure.

What Does Mnemonic AEIOU Tips Stand for?

This tips AEIOU mnemonic stand for:

A – Alcohol (overconsumption or withdrawal)

E – Epilepsy (seizure)

I – Insulin (overdose in diabetic patients)

O – Overdose (drugs)

U – Uraemia (renal failure)

T – Trauma

I – Infection (sepsis)

P – Psychiatric condition

S – Stroke/Shock

First responders are in an ideal position to identify the causes of Alcohol-induced Mental states (AMS). By recognizing the initial changes in a patient’s behavior, they can assess their immediate environment and detect signs of substance use.

Therefore, when equipped with mnemonic AEIOU TIPS protocol knowledge, first responders can better assist AMS patients.  

Alcohol

Those suffering from alcohol abuse can experience a collapse due to long-term drinking. Heavy drinkers may develop serious health issues and become more sensitive to specific medications, requiring more anesthesia than non-drinkers.

First responders must request any relevant information on the patient’s alcohol use from family members to inform medical professionals.

Furthermore, alcohol withdrawal can be a contributing factor to AMS. Binge drinkers, in particular, are likely to suffer uncomfortable symptoms such as sweating, insomnia, nausea, tremors, and anxiety after quitting their habit abruptly.

Thus, informed decisions must be made about managing this situation. Such as:

• Nausea
• Sweating
• Insomnia
• Agitation
• Mood swings
• Depression

While these symptoms are not life-threatening, some graver symptoms may arise on quitting alcohol cold turkey. One such symptom is Delirium Tremens (DT). Sudden interruption to the drinking habit affects the balance of brain chemicals and attacks the functioning of the central nervous system. In that scenario, a patient suffers from DT. Patients with DT can collapse from the disorientation of the brain. They can fall and become unconscious from any resulting head injury.

In other cases, DT has health complications that induce AMS. Investigating the incidents or symptoms leading to the patient’s unconscious state can reveal an underlying fatal condition. Stroke, cardiac arrest, and seizure are the most lethal outcomes of alcohol withdrawal. In each of these conditions, the patients pass out without prior warning.

First responders to such scenes may perform the AEIOU TIPS investigation with the patient’s family to identify the factor causing AMS. It can clarify the following:

• Whether the patient was a heavy drinker or not, this information will influence the use of any medication and its amount in the patient’s line of treatment. 
• Whether the patient has an alcohol abuse disorder or not, this information will help identify any fatal health complication requiring immediate medical attention.

Epilepsy

A grand mal seizure is characterized by a sudden burst of abnormal electrical activity passing through the brain, resulting in violent muscle contractions and loss of consciousness. Some patients may remain unconscious for several minutes after the convulsion ends; if this period extends longer, another underlying factor could be at play.

EMS personnel can perform an AEIOU TIPS analysis to determine whether epilepsy in the patient exhibits altered mental status (AMS). If not, they can investigate other possible causes and recommend treatment accordingly. 

In cases where the AMS patient has a history of epileptic seizures, medical professionals must follow the appropriate protocol. Otherwise, further physical tests may need to be conducted to check for signs of insulin overdose.

Insulin

Epilepsy is eliminated as a possible cause for altered mental status (AMS), and first responders may assess the patient for signs of an insulin overdose. People with diabetes can suffer from AMS after mistakenly ingesting too much insulin, resulting in low sugar levels due to increased glucose absorption into cells and decreased glucose production by the liver.

When assessing whether a patient has overdosed on insulin, first responders should look out for the following signs:

• Extreme hunger
• Irritability
• Anxiety 
• Confusion
• Sweaty/ clammy skin
• Trembling hands
• Fatigue

In cases of severe insulin overdose, the person may suffer from seizures or lose consciousness. Suppose a first-aider arrives after the individual has collapsed. In that case, they should conduct an AEIOU TIPS assessment by asking those nearby if they observed any of the symptoms mentioned above.

Overdose

In drug overdose cases, the body’s organs may be overwhelmed by the toxic chemicals ingested, forcing a person into a coma or cardiac arrest. EMS personnel must act fast to resolve this life-threatening condition.

Using AEIOU TIPS assessment, first responders can understand what type of drugs were taken (if any) and the quantity. This allows them to make informed decisions on treating patients with limited resources. Additionally, they must assess whether other conditions, such as high fever or infection, contribute to AMS.

Uraemia

Uraemia is caused by kidney failure due to reduced blood flow or accumulation of waste products in the bloodstream. It can lead to confusion, drowsiness, and unconsciousness. First responders must quickly identify the cause of AMS to provide appropriate medical treatment.

In such crises, first responders should use AEIOU TIPS assessment to investigate whether uremia is causing altered mental status (AMS). Obtaining information from family members and friends on any prior medical history will be vital in determining the right course of action.

Furthermore, EMS personnel should observe the patient for signs of high blood pressure or dehydration associated with uremia. They must also check for any infections, which could be a contributing factor. Once all necessary details have been collected, they can begin administering the required treatment.

Trauma

Trauma can also be a cause of altered mental status. In such cases, first responders must conduct an AEIOU TIPS assessment to identify the source and assess whether the patient has head injuries. If there is evidence of trauma, they should take extra precautions while attending to the patient to minimize any complications arising from further neurological damage.

Infections

Severe infections such as sepsis can also cause AMS. This infection occurs when bacteria spread through the bloodstream, leading to an inflammation of organs and tissues throughout the body. First responders must act quickly upon detecting signs of disease to prevent severe damage or death caused by sepsis. Through an AEIOU TIPS assessment, first responders can determine whether an infection is present and how best to treat it.

Psychiatric

Psychiatric conditions can also result in AMS. In such cases, first responders must assess the patient’s psychological state using AEIOU TIPS assessment to determine whether a medical condition or drug overdose is present. Additionally, they should observe the patient for any physical indications of trauma that may be causing or contributing to their altered mental status.

By conducting a thorough and systematic AEIOU TIPS assessment, first responders can identify the source of AMS and provide the most appropriate medical care. In some cases, this may involve referring the patient to a specialist for further treatment.

Stroke/Shock

Stroke or shock can also contribute to altered mental status. First responders must recognize the signs of stroke and act quickly before permanent damage occurs. An AEIOU TIPS assessment will help them determine whether the patient is suffering from a stroke and what steps need to be taken for treatment.

In cases where the patient has suffered a traumatic injury, first responders should take steps to prevent shock from setting in. This includes elevating the affected limb and providing oxygen therapy if necessary.

Final Words

Altered mental status mnemonic AEIOU TIPS assessment is a valuable tool for medical professionals to diagnose and treat changes in consciousness. By gathering information and conducting an appropriate investigation, first responders can identify the cause of AMS, provide suitable treatment and refer the patient to the right specialist if necessary.

By following this protocol, first responders can ensure that patients suffering from altered mental status receive the best possible care.

References:

https://en.wikipedia.org/wiki/AEIOU-TIPS#:~:text=AEIOU%2DTIPS%20is%20a%20mnemonic,causes%20for%20altered%20mental%20status.