Emergency Medicine

(Nancy Kaufman) #1
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)


  1. 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

  2. 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)

  3. 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)


  1. 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


  1. Or: Iā€™m 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
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