Who turned the lights out???

When thinking about altered level of awareness there are many possible approaches. A simple mnemonic is 'DIMS' . See below for the breakdown of what each letter stands for:

Drugs:

•Withdrawal : ETOH, benzodiazepines, narcotics, nicotine, antipsychotics

•Intoxication / interaction: anticholinergics (gravol), benzodiazepines, narcotics

Infections:

•urine, bacteremia, pneumonia, meningitis, encephalitis

Metabolic:

•Endocrine: Hypoglycemia / hyperglycemia, Thyroid

•Major organ failure: Lung; ­ hypercarbia, hypoxia, Kidney, Liver

•Electrolytes: ­ hypomagnesemia, hypercalcemia, hyper/hyponatremia

•Other: thiamine def.  B12 def. niacin def

Structural:

•Stroke : ischemic / hemorrhagic

•Subarachnoid hemorrhage

•Subdural hemorrhage

•Subacute: abscess, tumor

•Seizure (post ictal)