COMA
(Algorithmic Diagnosis of Symptoms and Signs)
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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, ... DIAGNOSTIC WORKUP
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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 ... DIAGNOSTIC WORKUP
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Is it true vertigo? True vertigo is characterized by the fact that the subject feels he or his environment is turning. One other form of true vertigo is lateral ... 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
.
... DIAGNOSTIC WORKUP
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A subjective sensory phenomenon that may involve any of the five senses, such as visual auras (often described as flashing lights), sensory auras (paresthesias), or auditory auras. Other auras... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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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... 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... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Dizziness/lightheadedness, a sensation of nearly losing consciousness, must be distinguished from vertigo, a sense of impulsion (spinning), either of the environment or of the patient. Dizziness... 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... 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... 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... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Vertigo is an illusion of movement (usually rotatory) due to an acute imbalance of tonic vestibular activity. Symptoms of vertigo are nonspecific and occur when there is a disturbance anywhere in the peripheral or... 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
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... Dizziness may mean true vertigo, which is a hallucination of movement of the patient or his environment, or light-headedness, which is a feeling that one is going to faint (and sometimes does). The causes
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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
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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
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Aura
(Handbook of Signs & Symptoms (Third Edition))
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... An aura is a sensory or motor phenomenon, idea, or emotion that marks the initial stage of a seizure or the approach of a classic migraine headache. Auras may be classified as cognitive, affective, psychosensory, or psychomotor. ... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... A common symptom, dizziness is a sensation of imbalance or faintness, sometimes associated with giddiness, weakness, confusion, and blurred or double vision. Episodes of dizziness are usually brief; they may... History and physical examination ... Medical causes ... Other causes ... Special considerations
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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... 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... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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... Vertigo is an illusion of movement in which the patient feels that he’s revolving in space (subjective vertigo) or that his surroundings are revolving around him (objective vertigo). He may complain of feeling... 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
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... Dizziness
Hyperventilation
Anxiety, psychosomatic causes
Hypoxia
Anemia
Visual
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... Usually No Lateralizing Signs, Normal Brainstem Reflexes
Drug withdrawal after chronic intoxication, especially
Alcohol
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Aura
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... An aura is a sensory or motor phenomenon, idea, or emotion that marks the initial stage of a seizure or the approach of a classic migraine headache. Auras may be classified as cognitive,... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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Dizziness
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... A common symptom, dizziness is a sensation of imbalance or faintness, sometimes associated with giddiness, weakness, confusion, and blurred or double vision. Episodes of dizziness are usually brief; they may be mild or severe with an... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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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.... Emergency Interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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Syncope
(Professional Guide to Signs & Symptoms (Fifth Edition))
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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... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling
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Vertigo
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Vertigo is an illusion of movement in which the patient feels that he’s revolving in space (subjective vertigo) or that his surroundings are revolving around him (objective vertigo). He may complain of feeling pulled... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers
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Coma
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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. ... History ... Physical examination ... Testing ... Diagnostic assessment.
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Delirium
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... 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... Approach. ... History ... Physical examination. ... Testing ... Diagnostic assessment.
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Dizziness
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... John Muench
Dizziness is a disturbance in a patient’s subjective sensation of relationship to space. It can be the clinical presentation for many different... Approach ... History. ... Physical examination. ... Testing ... Diagnostic assessment
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Syncope
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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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... Approach. ... History ... Physical examination ... Testing. ... Diagnostic assessment. ... Pictures
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Vertigo
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Frank S. Celestino
Dizziness accounts for 1% to 2% of all office visits, 7% of visits by patients aged more than 80 years and 20% to 25% of all non&ndash... Approach ... History ... Physical examination (PE) ... Testing ... Diagnostic assessment
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... Differential Overview
❑ Alcohol intoxication
❑ Drug overdose
❑ Hypoglycemia ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Vertigo
❑ Benign paroxysmal positional vertigo
❑ Vestibular neuronitis
&... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
Orthostatic/Autonomic
❑ Neurally mediated hypotension
❑ Volume depletion ... Diagnostic Approach ... Clinical Findings
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... Differential Overview
Systemic
❑ Drugs/toxins
❑ Sepsis
&... Diagnostic Approach ... Clinical Findings ... Pictures
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Dizziness
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... A common symptom, dizziness is a sensation of imbalance or faintness, sometimes associated with giddiness, weakness, confusion, and blurred or double vision. Episodes of dizziness are usually brief; they may be mild... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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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... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Syncope
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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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... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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Aura
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
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... An aura is a sensory or motor phenomenon, idea, or emotion that marks the initial stage of a seizure or the approach of a classic migraine headache. Auras may be classified as cognitive, affective, psychosensory, or... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... A common symptom, dizziness is a sensation of imbalance or faintness, sometimes associated with giddiness, weakness, confusion, and blurred or double vision. Episodes of dizziness are usually brief; they may be mild or severe with... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... 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... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Syncope
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
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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... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Vertigo
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
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... Vertigo is an illusion of movement in which the patient feels that he’s revolving in space (subjective vertigo) or that his surroundings are revolving around him (objective vertigo). He may complain of feeling as if he’s being... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Vertigo
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
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... Vertigois a disturbance of spatial orientation in which individuals havethe sensation that they or their surroundings are moving. Abnormalvestibular function, either in the peripheral or central... Principal Causes of Vertigo ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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...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... Principal Causes of Syncope and Dizziness ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... An aura is a sensory or motor phenomenon, idea, or emotion that marks the initial stage of a seizure or the approach of a classic migraine headache. Auras may be classified as cognitive, affective, psychosensory, or psychomotor. ... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... A common symptom, dizziness is a sensation of imbalance or faintness, sometimes associated with giddiness, weakness, confusion, and blurred or double vision. Episodes of dizziness are usually brief; they may be mild or... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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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... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... 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... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Vertigo is an illusion of movement in which the patient feels that he's revolving in space (subjective vertigo) or that his surroundings are revolving around him (objective vertigo). He may complain of... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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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
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Dizziness may mean true vertigo, which is a hallucination of movement
of the patient or his environment, or lightheadedness, which is a feeling
that one is going to faint (and sometimes does). The causes of ... Pictures
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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... Pictures
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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... Pictures
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... Phillip Spandorfer
Approach to the Patient with Syncope
I. Definition of the Complaint
Syncope is generally thought of as a ... Pictures
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... Author:
Anjali Subbaswamy, MD
What to Do - Gather Appropriate Data
Syncope/Long QT. Syncope is a loss of consciousness related to decreased ... Suggested Readings
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... Nancy Drucker, MD Syncope - BASICS Syncope - description Loss of consciousness, typically lasting no longer than 1–2 minutes, due to a transient drop in cerebral perfusion pressure ... Syncope - DIAGNOSIS ... Syncope - TREATMENT ... Syncope - FOLLOW UP ... Syncope - bibliography ... Syncope - CODES ... Syncope - FAQ
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