Coma
What is Coma? A persistent pathological state of unconsciousness. What do I do about it? In the comatose patient immediately ensure a clear airway, check that they are breathing, establish haemodynamic stability, and check for life-threatening injuries. Take a history from relatives or bystanders and ask if anyone saw how the patient became unconscious? Is there any past medical history such as diabetes, alcohol abuse, or drug overdose that might explain the coma? Examine the patient in an attempt to distinguish metabolic causes of coma from brainstem causes. It is particularly important to identify coma due to brainstem compression since surgical relief of the enlarging mass may be urgently required. Use the Glasgow coma score (GCS). Look for the following signs when reviewing the patient: Fever Meningitis or encephalitis Cerebral malaria Metabolic coma of infection Hypothermia Hypothyroidism; hypothermic coma Hypertension Coma m...