Orientation is a function of the

mind The mind is the set of faculties responsible for all mental phenomena. Often the term is also identified with the phenomena themselves. These faculties include thought, imagination, memory, will, and sensation. They are responsible for various m ...

involving awareness of three dimensions:

time Time is the continued sequence of existence and events that occurs in an apparently irreversible succession from the past, through the present, into the future. It is a component quantity of various measurements used to sequence events, to ...

place Place may refer to: Geography * Place (United States Census Bureau), defined as any concentration of population ** Census-designated place, a populated area lacking its own Municipality, municipal government * "Place", a type of street or road ...

and

person A person ( : people) is a being that has certain capacities or attributes such as reason, morality, consciousness or self-consciousness, and being a part of a culturally established form of social relations such as kinship, ownership of property, ...

. Problems with orientation lead to ''dis''orientation, and can be due to various conditions, from

delirium Delirium (also known as acute confusional state) is an organically caused decline from a previous baseline of mental function that develops over a short period of time, typically hours to days. Delirium is a syndrome encompassing disturbances in ...

intoxication Intoxication — or poisoning, especially by an alcoholic or narcotic substance — may refer to: * Substance intoxication: ** Alcohol intoxication ** LSD intoxication ** Toxidrome ** Tobacco intoxication ** Cannabis intoxication ** Cocaine i ...

. Typically, disorientation is first in time, then in place and finally in person.

Assessment

In the context of an accident or major trauma, the

Emergency Medical Responder Emergency medical responders are people who are specially trained to provide out-of-hospital care in medical emergencies. There are many different types of emergency medical responders, each with different levels of training, ranging from first ...

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 ''"awake, alert, and oriented, times three (to person, place, and time)."'' This is frequently abbreviated AAOx3 which also serves as a mnemonic. The assessment involves asking the patient to repeat his own full name, his present location, and today's date. The assessment is best done right up front, ahead of moving or transporting the victim, because it may illuminate potential internal damage. #Event/Situation - A fourth category is now used as well. If the person is oriented to what is going on around them, then they are said to be AAOx4. AAOx3 is not a concerning response since people are sometimes less aware of the situation due to pain, time of day, or lack of significant event. Alternately, the letters in AAOx4 can be documented as COAX4. A person who is COAx4 is said to be "conscious, alert, & oriented to person, place, time and event". When a handoff report is made, anything less than 4 is specifically noted for clarity (e.g., patient is COAx2, oriented to self and place). Mental orientation is closely related, and often intermixed with trauma shock, including physical shock (see:

Shock (circulatory) Shock is the state of insufficient blood flow to the tissues of the body as a result of problems with the circulatory system. Initial symptoms of shock may include weakness, fast heart rate, fast breathing, sweating, anxiety, and increased thi ...

) 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 The brainstem (or brain stem) is the posterior stalk-like part of the brain that connects the cerebrum with the spinal cord. In the human brain the brainstem is composed of the midbrain, the pons, and the medulla oblongata. The midbrain is conti ...

and the

cerebral hemisphere The vertebrate cerebrum (brain) is formed by two cerebral hemispheres that are separated by a groove, the longitudinal fissure. The brain can thus be described as being divided into left and right cerebral hemispheres. Each of these hemispheres ...

s have been reported to cause disorientation, suggesting that they act together in maintaining awareness and its subfunction of orientation.

Disorientation

Disorientation is the opposite of orientation. It is a

cognitive Cognition refers to "the mental action or process of acquiring knowledge and understanding through thought, experience, and the senses". It encompasses all aspects of intellectual functions and processes such as: perception, attention, thought, ...

disability in which the senses of time, direction, and

recognition Recognition may refer to: *Award, something given in recognition of an achievement Machine learning *Pattern recognition, a branch of machine learning which encompasses the meanings below Biometric * Recognition of human individuals, or biomet ...

of items (things), people and places become difficult to distinguish/identify.Isaac M., Janca A., Sartious N., 1994.''ICD-10 Symptom Glossery For Mental Disorders,''10th ed. WHO.

Causes of mental disorientation

Disorientation can occur in healthy young adults as well as in the elderly or ill person. While exercising, if a person becomes dehydrated as a result of over-exertion, he or she may become disoriented to the time or place. While exercising, the body may not be able to supply enough oxygen to the brain fast enough. Mental disorientation can be the aim of some performance art, as creators with 'audience disorientation' as a goal may work to deliberately augment sensations of time, place, person, purpose.

References

{{Psychophysiology Cognition

Assessment

Disorientation

Causes of mental disorientation

See also

References