ALTERED CONSCIOUS LEVEL
General Medical Emergencies 83
(v) Blood cultures, MSU.
(vi) ECG, CXR.
(vii) CT brain scan.
(viii) Lumbar puncture. See page 482.
Table 2.7 Mini-Mental State Examination (MMSE)
Cognition tested Score
Orientation (10 points)
- What is the date? 1
What is the day? 1
What is the month? 1
What is the year? 1
What is the season? 1 - What is the name of this building? 1
What floor of the building are we on? 1
What city are we in? 1
What state are we in? 1
What country are we in? 1
Registration (3 points) - I am going to name three objects. After I have
said them I want you to repeat them. Remember
what they are because I am going to ask you to
name them in a few minutes. Apple. Table. Penny.
(Code the first attempt and then repeat the
answers until the patient learns all three)
Apple 1
Table 1
Penny 1
Attention and calculation (5 points max)
- Either: Can you subtract 7 from 100, and then
subtract 7 from the answer you get and keep
subtracting until I tell you to stop?
93 1
86 1
79 1
72 1
65 1
- Or: Iām going to spell a word forwards and I
want you to spell it backwards. The word is
W-O-R-L-D. Now you spell it backwards
(Repeat if necessary)
D1
L1
R1
O1
W1