ABSTRACT
The initial approach to the pregnant patient with acute mental status (AMS) begins with a primary survey with the goal of first stabilizing the mother and then addressing the fetus. The airway, breathing, and circulation (ABCs) of advanced cardiac life support need to be immediately implemented and adapted to the pregnant patient, particularly deviating the uterus off the vena cava. This chapter provides a framework to guide both rapid treatment and deductive reasoning. Familiarity with the common presentations and causes of AMS allows the physician to care for both mother and fetus competently and safely. The ingestion of toxins, illegal substances, and medications is a common cause of AMS in the emergency room. Both alcohol intoxication and withdrawal can cause AMS. Intoxicated women present with euphoria incoordination, AMS, and even aggressive behavior. Medical history, physical examination, past history, and treatment response can lead to the diagnosis and treatment in 60% of cases of AMS.
