AEIOU-TIPS

AEIOU-TIPS is a mnemonic acronym used by some medical professionals to recall the possible causes for altered mental status. Medical literature discusses its utility in determining differential diagnoses in various special populations presenting with altered mental status, including infants,[1] children,[2] adolescents,[3] and the elderly.[4] The mnemonic also frequently appears in textbooks and reference books regarding emergency medicine in a variety of settings, from the emergency department[5] and standard emergency medical services[6] to wilderness medicine.[7]

The acronym

Component(s) of acronym Examples
A Alcohol/Abuse of substances
Acidosis		 Alcohol or drug intoxication[3]
Diabetic ketoacidosis;[1] hypoventilation due to COPD, asthmatic airway obstruction, or neuromuscular disease[2]
E Environmental
Epilepsy
Electrolytes
Encephalopathy
Endocrine disease		 Hypothermia; hyperthermia[7]
Epileptic seizure (or seizure for any other reason)[4]
Hyponatremia; hypernatremia; hypocalcemia; hypercalcemia[6]
Wernicke's encephalopathy; Chronic traumatic encephalopathy (CTE)[6]
Adrenal insufficiency; thyroid disease[2]
I Infection Encephalitis, meningitis, meningoencephalitis; sepsis[1]
O Overdose
Oxygen deficiency		 Prescription or non-prescription drug overdose[1][3]
Hypoxia due to pulmonary edema or tension pneumothorax; hypoxic brain injury due to cardiac arrest[4]
U Underdose
Uremia		 Insufficient dose of prescription medications
Excess urea in the blood due to kidney failure, congestive heart failure, urinary obstruction[6]
T Trauma
Tumor		 Concussion; traumatic brain injury; increased intracranial pressure due to epidural hemorrhage[7]
Brain tumor; metastasis to the brain; paraneoplastic syndrome[5]
I Insulin Hypoglycemia;[7] hyperosmolar hyperglycemic state[6]
P Psychogenic
Poisons		 Psychosis; pseudoseizure; conversion disorder[5]
Carbon monoxide poisoning; lead poisoning; iron poisoning[5]
S Stroke
Shock		 Hemorrhagic stroke due to arteriovenous malformation (AVM)[5]
Neurogenic shock due to spinal cord injury; cardiogenic shock due to myocardial infarction[6]

References

  1. 1 2 3 4 Avner JR 2006. "Altered States of Consciousness". Pediatrics in Review 27: 331–338. doi:10.1542/pir.27-9-331. Retrieved January 31, 2016.
  2. 1 2 3 Teitelbaum, Jonathan; Deantonis, Kathleen; Kahan, Scott (June 24, 2004). Pediatric Signs and Symptoms (1st ed.). Blackwell Publishing. pp. 177–180. ISBN 978-1405104272.
  3. 1 2 3 Akbary S; Kannikeswaran N 2012. "Acute Onset Altered Mental Status in a Previously Healthy Teenager". Pediatric Emergency Care (Lippincott Williams & Wilkins, Inc.) 28 (4): 376–379. doi:10.1097/PEC.0b013e31824d9d3f.
  4. 1 2 3 Melillo KD 1991. "Mnemonics: Use in Gerontological Nursing Practice". Journal of Gerontological Nursing 17 (7): 40–43. doi:10.3928/0098-9134-19910701-13.
  5. 1 2 3 4 5 Wolfson, Allan B.; Hendey, Gregory W.; et al. (2009). Clinical Practice of Emergency Medicine. Lippincott Williams & Wilkins, Inc. p. 1121. ISBN 9780781789431.
  6. 1 2 3 4 5 6 Sanders, Mick J.; McKenna, Kim D.; et al. (2011). Mosby’s Paramedic Textbook. Jones & Bartlett Publishers. p. 778. ISBN 9780323072755.
  7. 1 2 3 4 Forgey, M.D., William W. (November 6, 2012). Wilderness Medicine: Beyond First Aid (6th ed.). Morris Book Publishing, Inc. ISBN 978-0762780709.
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