The doctor will perform a physical examination and ask questions such as:

• Does the person get days and nights mixed up? Are they awake during their usual sleep time?
• Do they recognize people?
• Do they know where they are?
• Do they know the date and time?
• Can they answer questions appropriately?
• Is the person always confused?
• Are there repeated episodes?
• Is the confusion rapidly getting worse?
• Does the confusion come and go?
• Has there been any recent illness?
• Has there been a recent head injury?
• Is the person diabetic?
• Does the person have COPD, chronic bronchitis, or a similar lung disorder?
• What medications is the person taking?
• Has there been any exposure to other drugs or alcohol?

The physical examination will include a thorough evaluation of brain and nervous system function. Neurologic tests and cognitive tests may be performed. Tests such as an MRI of the head, blood and urine tests, and an EEG may be indicated, depending upon accompanying signs and symptoms.

• Obtain a regular amount of sleep
• Eat a balanced diet with plenty of vitamins and minerals.
• Don't drink alcohol in excess.
• Keep careful control of your blood sugar if you have diabetes.
• Quit smoking, which puts you at greater risk for lung diseases.

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Leclerc S, Lassonde M, Delaney J S et al. Recommendations for grading of concussion in athletes. Sports Med. 2001; 31: 629-636.

Bazakis AM, Kunzler C. Altered Mental Status Due to Metabolic or Endocrine Disorders. Emer Med Clinics of North America. 2005; 23(3): 901-908.

Biem J. Out of the cold: management of hypothermia and frostbite. CMAJ. 2003; 168(3): 305-311.