STEP 1 : Assessment 

1. Level of Consciousness

Assess patients level of consciousnesses using AVPU or GCS

AVPU

• Alert
  
• Voice
  
• Pain 
  
• Unresponsive
  

GCS

Eye movement

Verbal response

Motor response

2. Assess blood glucose 

• Check for hypoglycemia
  

• Raised Intracranial Pressure : Unequal pupils
• Opiate over-dose : Constricted pupils

5. Observe for convulsions

STEP 2: Management

i. Recovery position

• Stable patient with altered mental status with no suspicion of spinal or head injury
  

ii. Glucose

• Patient with hypoglycemia
  

iii. Benzodiazapine

• Patient with seizures
  

•   Eclampsia

Opiate over-dose  (constricted  pupils and slow breathing)

vi. Raised ICP

• Elevate head pf  bed to 30 degrees

• Immobilize C-spine 
  
• LOG roll