{
  "card_id": "AMS-RED-FLAGS-v1",
  "title": "Altered mental status red flags",
  "applies_to": [
    "all ages",
    "field clinic",
    "disaster response"
  ],
  "required_observations": [
    "baseline mental status if known",
    "current alertness",
    "confusion or behavior change",
    "seizure report",
    "head injury or toxin exposure report",
    "available vital signs"
  ],
  "red_flags": [
    "new confusion or altered mental status",
    "unresponsive or difficult to arouse",
    "new seizure",
    "severe weakness with confusion",
    "altered mental status after injury, toxin exposure, fever, or breathing concern"
  ],
  "escalation_criteria": [
    "New altered mental status, unresponsiveness, or seizure requires emergency escalation according to local protocol.",
    "If the person cannot provide reliable history, treat missing information as important for handoff rather than reassurance."
  ],
  "local_actions": [
    "Document baseline if known, current alertness, timeline, associated symptoms, and vital signs for handoff.",
    "Keep the person under direct observation while escalation is arranged."
  ],
  "forbidden_actions": [
    "Do not diagnose the cause of altered mental status.",
    "Do not provide medication, dosing, restraint, or procedure instructions unless a local clinician or protocol explicitly provides them."
  ],
  "safety_boundary": "Prototype protocol navigation card for trained-responder review only. It is not a clinical guideline and cannot diagnose, prescribe, dose, triage autonomously, or override local protocol.",
  "source_note": "Prototype protocol card derived from public guideline concepts. Not a clinical guideline."
}