Browse categories and answer follow-up questions to refine your symptom profile.
Immediate priorities
First look stabilization
Airway protection concern
GCS 8 or less with loss of protective reflexes
Recurrent emesis with inability to protect airway
Copious secretions or aspiration concern
Breathing compromise
RR less than 8 or apneic episodes
SpO2 less than 92% on room air
Suspected aspiration pneumonitis
Circulatory instability
SBP less than 90 mmHg after positioning
Shock index greater than 1
Active bleeding or major trauma concern
Immediate bedside tests
Capillary glucose
Core temperature
Monitoring and access
Continuous pulse oximetry
Supplemental oxygen if hypoxemic
High flow or NIV only if airway reflexes intact
Cardiac monitoring
Dysrhythmia triggers
QT prolongation triggers
IV access
Two large bore IVs if trauma or hypotension
IO access if unable to obtain IV and unstable
Frequent reassessment interval
Every 5 to 15 minutes if unstable
Every 30 to 60 minutes if improving
High risk features
Red flag features
Head trauma or anticoagulant use
New focal neurologic deficit
Persistent altered level of consciousness
Co-ingestion concern
Suspected opioids
Suspected sedative hypnotics
Metabolic or infectious alternative
Fever
Meningismus
Severe toxidrome
Seizure
Severe agitation with hyperthermia
Immediate triggers for escalation
Escalation triggers
If hypoglycemia, then immediate dextrose protocol
Glucose less than 3.0 mmol/L
Recheck glucose in 10 minutes
If suspected opioid co-ingestion, then naloxone protocol
Bradypnea or apnea
Pinpoint pupils with hypoventilation
If refractory vomiting or aspiration, then airway management pathway
Inability to tolerate positioning
SpO2 decline despite oxygen
If severe agitation, then chemical sedation pathway
Threat to staff safety
Unable to complete essential evaluation
Key concepts
Clinical framing
Alcohol intoxication is a diagnosis of exclusion until dangerous alternatives addressed
Ethanol level poorly predicts clinical impairment in tolerant patients
Altered mental status requires glucose check before attributing to ethanol
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.