Most patients with hepatic encephalopathy before the onset of temper personality changes, abnormal mood or behavior disorder. If the performance is euphoric excited, be agitated, insomnia many language, speech is not clear, have hallucination even. Paramedics must be on the lookout. When these symptoms occur, talk to the patient and ask specific questions to understand the patient's reactivity and computational comprehension. Inform the doctor if any problem is found and follow the doctor's advice.