Author Archives: DrC

TIPS/VOWELS Mnemonic: For Differential Diagnosis Of Altered Mental State And Coma

Altered Mental State [AMS] D. Collman, M.D. Introduction: Consciousness  is intricately tied to the dynamic interplay between the reticular activating system [RAS] and the cerebral cortex. The RAS governs the general state of alertness and wakefulness, while the cerebral cortex manages higher cognitive functions. Dysfunction in either or both these systems can lead to aContinue reading “TIPS/VOWELS Mnemonic: For Differential Diagnosis Of Altered Mental State And Coma”

This is the simple algorithm I have presented for decades to teach the approach to all EM cases. The amount of oxygen, the types of monitors and the fluid resuscitation are personalized for each patient.

Digital art by Dr Collman including medical illustrations are available for purchase. He can create art or modify any image to your specifications. He has published art for medical texts and magazines as well produced fine art for over 50 years.

The RBC

What is the diagnosis in each of these six patients? Assume they all arrive at the same time, i.e., this is a mass casualty event – How would you prioritize the overall management and transfer of any of these patients to a neurosurgeon?

Discussion: note: (On exams some images are field test items [not scored]. In this group the lower middle slice is of a patient who would likely arrive dead: he has a massive SAH that surrounds all of the cortical surfaces/even extends a long the falx in the midline [appears fuzzy due to blood filling theContinue reading “What is the diagnosis in each of these six patients? Assume they all arrive at the same time, i.e., this is a mass casualty event – How would you prioritize the overall management and transfer of any of these patients to a neurosurgeon?”