Today’s pearl is courtesy of the AM report. When evaluating the lethargic pediatric patient there’s lots to consider. Here’s a mnemonic, that if you can remember it (write it down) could be elucidating.

 

Carbon monoxide poisoning
Overdose
Metabolic derangement/disorder
Abuse/alcohol/asphyxia
Trauma
Organic acidosis¬†(that’s metabolic d/o again)
Seizure/shock
Encephalopathy

Psychiatric disturbance
Acidosis/alkalosis
Tumor
Insulin/intussusception
Endocrine disorder
Narcosis
Temperature (high or low)

 

Ref: Lana Tobin-Friedman, MD