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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 depressants. ... 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 ... DIAGNOSTIC WORKUP
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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 possibility of major cardiac or... 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 brainstem or both combined.... 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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... 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 produces
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... 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
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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... 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 a feeling of light-headedness.... 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)
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... Usually No Lateralizing Signs, Normal Brainstem Reflexes
Drug withdrawal after chronic intoxication, especially
Alcohol
Barbiturates
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... 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,... 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 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... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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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 considered a... History ... Physical examination ... Testing ... Diagnostic assessment.
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... 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... Approach. ... History ... Physical examination ... Testing. ... Diagnostic assessment. ... Pictures
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... Differential Overview
❑ Alcohol intoxication
❑ Drug overdose
❑ Hypoglycemia
❑ Metabolic acidosis
❑... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Orthostatic/Autonomic
❑ Neurally mediated hypotension
❑ Volume depletion
❑ Cough... Diagnostic Approach ... Clinical Findings
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... 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... 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... 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... 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... Principal Causes of Syncope and Dizziness ... 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... 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 starts as a feeling of light... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
... 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 the... 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. The few... Pictures
... READ EXCERPTS »
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