Recent diagnosis urinary tract infection with new onset confusion part 3


• Transported to hospital


Elliot Williams, Paramedic Woodburn Ambulance


David M. Spiro, MD, MPH Professor of Pediatrics University of Arkansas Medical Center


• Urosepsis

Differential Diagnosis

• Encephalopathy
• CVA (stroke)
• Myocardial infarction
• Drug overdose or adverse drug reaction (eval new medications)
• Hypertensive encephalopathy
• Renal failure
• Electrolyte abnormality
• Urosepsis
• Dehydration

Patient Workup

• CBG = 117 on scene= 117 on scene

Key Points

• Initially the medic towers over the pt but then corrects himself and gets down to eye level
• Pt seems to be confused enough to require the use of implied consent for transport if she does not want to go to the hospital (not oriented to place or year)

Editor’s Notes

Further assessment should include 12 lead, temperature, mini neuro and mental status exam. Lactate if available. If mental status change is acute; she will need an IV lock

– David Tauber, Paramedic Program Director, Yale University

Suggested References

Altered mental status in the elderly


• Gender: Female
• Age: 96 years
• Weight: Not Available
• Height: Not Available


• Temperature: Not Available
• Blood Pressure: 157/77
• Heart Rate: 77
• Respiratory Rate: 16
• Pulse Oximetry: 94%

Signs and Symptoms

Recent diagnosis, urinary tract infection; presents with confusion

History Medical

• Recent diagnosis, Urinary tract infection
• Congestive heart failure (CHF)
• S/P left mastectomy


• Ciprofloxacin

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