What should be assessed first when encountering a patient with altered mental status?

When encountering a patient with altered mental status, assessing the level of consciousness is crucial because it provides immediate insights into the patient's neurological status. This involves evaluating how alert the patient is, their ability to respond to stimuli, and their orientation to person, place, time, and situation.

Understanding the level of consciousness helps to determine the severity of the altered mental status and guides further assessment and interventions. It can indicate underlying issues (such as head trauma, stroke, or infection) that require urgent medical attention. A clear assessment of consciousness is foundational before exploring other factors such as breathing patterns or glucose levels, as it directly reflects the patient's overall neurological function and could prioritize life-threatening conditions.

While factors like breathing patterns and blood glucose levels are indeed important in a comprehensive assessment, the level of consciousness should be evaluated first because it sets the stage for understanding the full clinical picture of the patient.