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Is there associated fever? Delirium with fever may simply indicate a self-limited infectious process, but it should bring to mind encephalitis and meningitis as well as cerebral abscess and cerebral hemorrhage.
Is there a ... DIAGNOSTIC WORKUP
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...
Are there convulsive movements or incontinence? The presence of convulsive movements should suggest convulsions, and the differential diagnosis of this is discussed on
page 88
.
Convulsive movements can ... DIAGNOSTIC WORKUP
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...
Is there a history of drug or alcohol ingestion? This is a very important question to ask, as many cases of coma are due to acute alcohol intoxication, delirium tremens, opium poisoning, barbiturate poisoning, and other toxic cerebral ... DIAGNOSTIC WORKUP
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...
An acute confusional state caused by a disturbance in global cortical function. Features include disturbance of consciousness, change in cognition, fluctuations of symptoms, and evidence that the condition is secondary to an underlying medical... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Syncope is often referred to by patients as “fainting” and is defined as a loss of postural tone and consciousness. Syncope usually lasts for brief periods of a few minutes. Longer periods are of more concern, because of the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Delirium is an alteration in consciousness that can be associated with hallucinations, disorientation, and delusions. Normal thought processes are altered, including judgment, and rational behavior may be lost. Causes are typically metabolic... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Syncope is temporary loss of consciousness and muscle tone due to decreased cerebral blood flow. It is otherwise known as fainting or blackout. Syncope is a common pediatric problem that, in contrast to that in adults, usually has a benign etiology. However, it can be a sign of a serious... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Coma is a state of total unawareness of the self and the environment. There is no eye opening or response to voice or painful stimuli. Coma can be due to dysfunction of either bilateral cerebral cortex or the reticular activating system in the... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... The differential diagnosis of delirium is very similar to that for coma and one finds the mnemonic VINDICATE useful in this regard.
V—Vascular disorders of the brain including hemorrhage, embolism, thrombosis, and
... READ EXCERPTS »
... The differential of syncope or a brief loss of consciousness is best developed with the use of physiology and, to a lesser extent, anatomy. Like convulsions (see page 128), syncope is due to a diminished supply of oxygen and glucose in the brain cell. Anything that
... READ EXCERPTS »
... Somnolence is a deep sleep from which the patient can be aroused. Coma is an unconscious state from which the patient cannot be aroused. Because somnolence may be simply an early stage of coma, its etiologies are almost all identical to the etiologies of coma. The few exceptions are mentioned
... READ EXCERPTS »
... A decrease in the level of consciousness (LOC), from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as hemorrhage, trauma, or cerebral edema. However, this sign can also result from a metabolic,... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... A common neurologic sign, syncope (or fainting) refers to a transient loss of consciousness associated with impaired cerebral blood supply or cerebral hypoxia. It usually occurs abruptly and lasts for seconds to minutes. An episode of syncope usually starts as... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Neurologic or Mechanical Causes, or Both
Mediated by vagal stimulation or autonomic insufficiency, or both
Vasovagal reaction (often associated with strong emotion or pain)
... READ EXCERPTS »
... Usually No Lateralizing Signs, Normal Brainstem Reflexes
Drug withdrawal after chronic intoxication, especially
Alcohol
Barbiturates
... READ EXCERPTS »
... Congenital
Antithrombin III deficiency
Protein C deficiency
Protein S deficiency
Homocystinuria
Dysfibrinogenemias
Hyperlipidemia
... READ EXCERPTS »
... A decrease in level of consciousness (LOC), from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as hemorrhage, trauma, or cerebral edema. However, this sign can also result from a metabolic, GI,... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
... READ EXCERPTS »
... A common neurologic sign, syncope (or fainting) refers to transient loss of consciousness associated with impaired cerebral blood supply or cerebral hypoxia. It usually occurs abruptly and lasts for seconds to minutes. An episode of syncope usually starts... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
... READ EXCERPTS »
... Linda P. Shields
Delirium, as defined by the Diagnostic and Statistical Manual of Mental Disorders, 4th edition criterion (1), is a condition involving an acute confusional state recognized by the patient’s change in consciousness,... Approach. ... History ... Physical examination. ... Testing ... Diagnostic assessment.
... READ EXCERPTS »
... James C. Chesnutt
Syncope is a common and concerning medical problem, which accounts for 3% of emergency room visits and up to 6% of hospital admissions. Although the cause of syncope can be life-threatening (e.g., ventricular tachycardia) and the... Approach. ... History ... Physical examination ... Testing. ... Diagnostic assessment. ... Pictures
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... Anne Cather Cutlip
Coma represents a state of unarousable unresponsiveness in which the patient has no evidence of self or environmental awareness (1).
Approach. A patient presenting with coma should be... History ... Physical examination ... Testing ... Diagnostic assessment.
... READ EXCERPTS »
... Differential Overview
Orthostatic/Autonomic
❑ Neurally mediated hypotension
❑ Volume depletion
❑ Cough syncope ... Diagnostic Approach ... Clinical Findings
... READ EXCERPTS »
... Differential Overview
❑ Alcohol intoxication
❑ Drug overdose
❑ Hypoglycemia
❑ Metabolic acidosis
❑... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... Differential Overview
Systemic
❑ Drugs/toxins
❑ Sepsis
❑ Hypoglycemia
❑ Hypercalcemia ... Diagnostic Approach ... Clinical Findings ... Pictures
... READ EXCERPTS »
... A decrease in level of consciousness (LOC), from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as hemorrhage, trauma, or cerebral edema. However, this sign can also result from... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A common neurologic sign, syncope (or fainting) refers to transient loss of consciousness associated with impaired cerebral blood supply or cerebral hypoxia. It usually occurs abruptly and lasts for seconds to minutes. An episode of syncope usually starts as a... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
... A decrease in level of consciousness (LOC), which can range from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as hemorrhage, trauma, or cerebral edema. However, this sign can also result from metabolic,... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
... A common neurologic sign, syncope (or fainting) refers to transient loss of consciousness associated with impaired cerebral blood supply or cerebral hypoxia. It usually occurs abruptly and lasts for seconds to minutes. An episode of syncope usually starts as a feeling of light-headedness.... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
... READ EXCERPTS »
...Syncope is a transient loss of consciousnessand postural tone usually produced by impaired cerebral blood flow.Generally, a syncopal episode in childhood is a benign isolatedevent; however, some causes can be life threatening. Because dizzinessoften precedes syncope, it... Principal Causes of Syncope and Dizziness ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Consciousness—awarenessof one's self and environment—depends on integrityof reticular activating system and cerebral hemispheres. Disease processes that depress reticularactivating system and/or both cerebral hemispheres causealteration... Principal Causes of Alteration in Consciousness ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... A decrease in the level of consciousness (LOC), from lethargy to stupor to coma, usually results from a neurologic disorder and may signal a life-threatening complication, such as hemorrhage, trauma, or cerebral edema. However, this sign can also result from a metabolic, GI... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
... READ EXCERPTS »
... A common neurologic sign, syncope (or fainting) refers to a transient loss of consciousness associated with impaired cerebral blood supply or cerebral hypoxia. It usually occurs abruptly and lasts for seconds to minutes. An episode of syncope usually... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... READ EXCERPTS »
...
The differential diagnosis of delirium is very similar to that for
coma, and one finds the mnemonic VINDICATE useful in this regard.
V—Vascular disorders of the brain including hemorrhage, embolism,
thrombosis, and
... READ EXCERPTS »
...
The differential of syncope or a brief loss of consciousness is best
developed with the use of physiology and, to a lesser extent,
anatomy. Like convulsions , syncope is due to a diminished supply of oxygen and glucose
in... Pictures
... READ EXCERPTS »
...
Somnolence is a deep sleep from which the patient can be aroused. Coma
is an unconscious state from which the patient cannot be aroused. Because
somnolence may be simply an early stage of coma, its etiologies are almost
all identical to the etiologies of coma.... Pictures
... READ EXCERPTS »
... Author:
Esther Forrester, MD
What to Do - Make a Decision
To have a thorough understanding of fluid and electrolyte issues, one must
truly understand the body's composition of solutes and water and how equilibrium is maintained in normal... Suggested Readings ... Pictures
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... Author:
Renée Roberts, MD
What to Do - Make a Decision
The mediastinum is comprised of superior, anterior, middle, and posterior
compartments; however, masses in the anterosuperior compartment of children can be extremely unstable... Suggested Readings
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... Amy R. Brooks-Kayal, MDEric Marsh, MD, PhD Coma - BASICS Coma - description Coma is defined as a state in which the patient is unresponsive with eyes closed, usually lasting <24 hours. Coma is a medical emergency,>... Coma - DIAGNOSIS ... Coma - TREATMENT ... Coma - FOLLOW UP ... Coma - bibliography ... Coma - CODES ... Coma - FAQ
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Getting babies to sleep can sometimes seem like a Herculean undertaking. Listen to a sleep expert's tips on what you can do to make bedtime a...
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