What is Disorientation?
Orientation is a function of the mind involving awareness of three dimensions: time, place and person. Problems with orientation lead to disorientation, and can be due to various conditions, from delirium to intoxication. Typically, disorientation is first in time, then in place and finally in person.
In the context of an accident or major trauma, the Emergency Medical Responder performs spiraling (increasingly detailed) assessments which guide the critical first response. Assessment of mental orientation typically lands within the immediate top three priorities:
- Safety - Assess the area safety (potential traffic, fire, overhead/underfoot objects and collapse risks, rushing water, gunfire, chemical/radiation threats, storm conditions, downed power lines, etc.), wait for the threat to subside, or move the person to safety if and when possible, all without endangering oneself.
- ABCs - Note conscious or unconscious then assess Airway, Breathing and Circulation factors (with priority to any potential gross or debilitating blood loss.)
- Orientation - Determine if the person is "alert and oriented, times three (to person, place, and time)." This is frequently abbreviated A&Ox3 which also serves as a mnemonic. The assessment is best done right up front, ahead of moving or transporting the victim, because it may illuminate potential internal damage.
Mental orientation is closely related, and often intermixed with trauma shock, including physical shock (see: Shock (circulatory)) and mental shock (see: Acute stress reaction, a psychological condition in response to terrifying events.)
The exact cerebral region involved in orientation is uncertain, but lesions of the brain stem and the cerebral hemispheres have been reported to cause disorientation, suggesting that they act together in maintaining awareness and its subfunction of orientation.