Coma (1) Flashcards
What is it?
What is it assessed by?
What’s its most common cause?
→ What are its other causes?
What are its clinical features?
➊ Deep state of prolonged, unarousable unconsciousness in which a person fails to respond normally to painful stimuli, light, or sound, lacks a normal wake-sleep cycle and does not initiate voluntary actions
➋ GCS
➌ Drug poisoning
→ • Hypoxia
• Hypoglycaemia
• Stroke
• Trauma
• Hypothermia
• Infection e.g. meningitis
➍ • GCS ≤ 8 lasting 6+ hrs
• Inability to voluntarily open the eyes
• Non-existent sleep-wake cycle
• Lack of response to painful/verbal stimuli
• Pupils not responding to light
• Irregular breathing
Which investigations need to be done?
How can it be managed?
➊ • A-E - Including GCS, and if PEARL
• Basic obs and general examination, checking for potential indicators for a cause e.g. needle marks, alcohol smell, meningism, trauma
• Collaterall hx if possible
• Bloods - FBC, U&E, CRP, LFT, Ethanol, Drug screen, VBG
• Urine toxicology
• CXR, CT Head
➋ • Correct any hypoglycaemia
• IV Pabrinex if alcohol withdrawal
• IV Naloxone if opioid OD
• IV Flumazenil for benzo OD
