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Pediatric Rounds Review Questions
Acute Mental Status Changes, Hypotension, and Bradycardia in a 15-Year-Old-Boy

Answer 1

  1. Routine urine drug screening. Although routine drug screening should be considered in all pediatric patients with acute mental status changes, the test screens for amphetamines, barbiturates, cocaine, marijuana, benzodiazepines and opioids, which are less likely to have played a role in this scenario. Tests for acute head trauma from a fall from the counter (head computed tomography), respiratory depression accompanying acute mental status changes (pulse oximetry), and hypoglycemia from oral medications for diabetes (glucose levels) are more likely to reveal abnormalities in this age group and scenario. In addition, reviewing all medications in the home may reveal what medication was on the counter.

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Updated 7/19/07 • kkj