A better way to think about Altered Mental Status

I recently had occasion to prepare a talk on the various causes of Altered Mental Status. As it happens, EM:RAP had a nice Continuous Core Content segment recently on the same topic. (Don't listen to EM:RAP? You should. Want to try it for free? Rob Orman of ERCast has an offer for a three month free trial. Use the code ERTHANKS.)* They used a practical case-based format to structure the approach, which I like, but also fell back on the old mnemonic of AEIOU TIPS. God I hate that mnemonic. It's so haphazard and utterly disorganized: just like the typical approach to AMS.A — Alcohol/Acidosis (not the same thing or in any way logically connected) E — Endocrine/Epilepsy/Electrolytes/Encephalopathy (E is a common letter?) I — Infection or maybe Ingestion who the hell knows nobody agreesO — Opiates, Overdose (sorta the same thing but ehhh) U — Uremia (not likely but something's gotta start with U) T — Trauma (garbage pail) I — Insulin (huh?) P — Poisoning/Psychosis S — Stroke/Seizure/syncope (wait syncope doesn't, and wasn't epilepsy already covered?) This is just terrible. Too many things thrown into too few headers with absolutely no logical connection between any of them and criminally incomplete to boot. Bad for learners, and pretty useless for recall too. My approach was to ask myself, well, AMS basically means the brain's not working right, right? Let's group the causes...
Source: Movin' Meat - Category: Emergency Medicine Source Type: blogs