A few topics will be covered in more detail in this module that won’t be highlighted in subsequent modules. Identifying casualties with altered mental status is important, as this can significantly affect the TTA.

Altered mental status has several potential causes, such as metabolic, toxic, and infectious, but in the combat or trauma environment, the principal causes are traumatic brain injury, hypoxia, and hypovolemia from blood loss. Also, hypothermia, although not typically a primary cause, can exacerbate mental status changes.

Some pain medications can alter a casualty’s mental status, and this should be considered when assessing the casualty. Through determining the mechanism of injury and attempting to communicate with the casualty while assessing their verbal and nonverbal responses, you can determine if a casualty is not responding appropriately and exhibiting signs and symptoms of an altered mental status.