Serotonin Syndrome: Consider in the Older Patient with Altered Mental Status
What’s the first thing that pops into your head when you see an older woman presenting to the ED from a nursing facility with atraumatic altered mental status? If you’re like me, ‘UTI’ comes quickly to mind. I then banish the thought of a UTI and force myself to go through a worst-first differential diagnosis to exclude, either through the history and clinical assessment or through testing, more dangerous causes. This is a case of a 67-year-old woman with an unusual cause of altered mental status… and a UTI.
Have you ever identified elder abuse in a patient in your ED? The signs can often be subtle, can look like one of many other medical or traumatic problems, and can be mistaken for aging-related changes. This is an unpleasant topic, but rather than bury our heads in the sand and pretend it doesn’t happen, let’s face it and see what we can do to intervene and help. How can you miss it less often? And what are your legal obligations if you suspect elder abuse?
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