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; Respiratory acidosis due to CO2 narcosia hypoventilation due to COPD, asthmatic airway obstruction, or neuromuscular disease[2]
E Ecstasy

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, pulmonary embolism or tension pneumothorax; hypoxic brain injury due to cardiac arrest[4]

[1]

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
Intestinal		 Hypoglycemia;[7] hyperosmolar hyperglycemic state[6]
Intussusception; Intestinal malrotation with volvulus[8]
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. Avner JR (2006). "Altered States of Consciousness". Pediatrics in Review. 27 (9): 331–338. doi:10.1542/pir.27-9-331. PMID 16950938. Retrieved January 31, 2016.
  2. Teitelbaum, Jonathan; Deantonis, Kathleen; Kahan, Scott (June 24, 2004). Pediatric Signs and Symptoms (1st ed.). Blackwell Publishing. pp. 177–180. ISBN 978-1405104272.
  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. PMID 22472657.
  4. Melillo KD (1991). "Mnemonics: Use in Gerontological Nursing Practice". Journal of Gerontological Nursing. 17 (7): 40–43. doi:10.3928/0098-9134-19910701-13. PMID 2071857.
  5. Wolfson, Allan B.; Hendey, Gregory W.; et al. (2009). Clinical Practice of Emergency Medicine. Lippincott Williams & Wilkins, Inc. p. 1121. ISBN 9780781789431.
  6. Sanders, Mick J.; McKenna, Kim D.; et al. (2011). Mosby's Paramedic Textbook. Jones & Bartlett Publishers. p. 778. ISBN 9780323072755.
  7. Forgey, M.D., William W. (November 6, 2012). Wilderness Medicine: Beyond First Aid (6th ed.). Morris Book Publishing, Inc. ISBN 978-0762780709.
  8. Stokes, H.; Ihidero, O.; Fox, G.; O'Neill, M. (2011). "Case 2: Coma in an apparently well toddler". Paediatrics & Child Health. 16 (8): 465–467. doi:10.1093/pch/16.8.465. PMC 3202383. PMID 23024582.
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