意识水平或警觉性突发改变的既往史:可能的病因包括脑血管病(短暂性脑缺血发作、卒中、癫痫发作)、心血管疾病(低血压、心动过缓或心动过速)、药物(尤其新开具的处方药物)治疗副作用或感染。[36]Brignole M. Diagnosis and treatment of syncope. Heart. 2007 Jan;93(1):130-6.http://www.ncbi.nlm.nih.gov/pubmed/17170354?tool=bestpractice.com
新发颅脑创伤:同时使用抗凝治疗或抗血小板治疗,应引起对硬膜下血肿形成的关注。[37]Ohm C, Mina A, Howells G, et al. Effects of antiplatelet agents on outcomes for elderly patients with traumatic intracranial hemorrhage. J Trauma. 2005 Mar;58(3):518-22.http://www.ncbi.nlm.nih.gov/pubmed/15761345?tool=bestpractice.com
疼痛提示可能的骨折:持续疼痛、不能负重或任何明显的解剖异常,提示应快速评估有无骨折,并在恰当时请骨科会诊。对于由冲击力小的跌倒导致骨折的患者,应考虑对骨质疏松加以治疗。[38]Feldstein A, Elmer PJ, Orwoll E, et al. Bone mineral density measurement and treatment for osteoporosis in older individuals with fractures: a gap in evidence-based practice guideline implementation. Arch Intern Med. 2003 Oct 13;163(18):2165-72.http://archinte.jamanetwork.com/article.aspx?articleid=216119http://www.ncbi.nlm.nih.gov/pubmed/14557214?tool=bestpractice.com