Disorders of Consciousness

Disorders of Consciousness: Somnolence, Sopor and Coma: Medical History

Medical history (history of illness) represents an important component in the diagnosis of disorders of consciousness* . Family History Are there any disorders in your family that are common? Social history Is there any evidence of psychosocial stress or strain due to your family situation? Current medical history/systemic history (somatic and psychological complaints) [third-party history, … Disorders of Consciousness: Somnolence, Sopor and Coma: Medical History

Disorders of Consciousness: Somnolence, Sopor and Coma: Or something else? Differential Diagnosis

Conditions that may cause disorders of consciousness: Respiratory System (J00-J99) Coma hypercapnium – coma caused by a marked increase in the level of carbon dioxide in the blood. Endocrine, nutritional and metabolic diseases (E00-E90). Addison’s crisis – decompensated Addison’s disease; this describes primary adrenocortical insufficiency resulting in, among other things, failure of cortisol production. Coma … Disorders of Consciousness: Somnolence, Sopor and Coma: Or something else? Differential Diagnosis

Disorders of Consciousness: Somnolence, Sopor and Coma: Examination

A comprehensive clinical examination is the basis for selecting further diagnostic steps. In principle, an emergency physical examination must be performed first in persons who are unconscious: Glasgow Coma Scale (GCS) – scale for estimating impaired consciousness. Criterion Score Eye opening spontaneous 4 on request 3 on pain stimulus 2 no reaction 1 Verbal communication … Disorders of Consciousness: Somnolence, Sopor and Coma: Examination

Disorders of Consciousness: Somnolence, Sopor and Coma: Test and Diagnosis

Laboratory parameters of the 1st order – obligatory laboratory tests. Small blood count Inflammatory parameters – CRP (C-reactive protein). Urine status (rapid test for: pH, leukocytes, nitrite, protein, glucose, ketone, urobilinogen, bilirubin, blood). Electrolytes – sodium, potassium, chloride, calcium. Fasting glucose (fasting blood glucose). Blood gas analysis (ABG); determination of. Venous: pH, BE, HCO3 -, … Disorders of Consciousness: Somnolence, Sopor and Coma: Test and Diagnosis

Disorders of Consciousness: Somnolence, Sopor and Coma: Diagnostic Tests

Obligatory medical device diagnostics. Electrocardiogram (ECG; recording of the electrical activity of the heart muscle). X-ray of the thorax (X-ray thorax/chest), in two planes. Optional medical device diagnostics – depending on the results of the history, physical examination and obligatory laboratory parameters – for differential diagnostic clarification. Computed tomography/magnetic resonance imaging of the skull (cranial … Disorders of Consciousness: Somnolence, Sopor and Coma: Diagnostic Tests

Disorders of Consciousness: Somnolence, Sopor and Coma: Symptoms, Complaints, Signs

The following symptoms and complaints may indicate Somnolence, Sopor and Coma (disorders of consciousness): Leading symptoms of somnolence Drowsiness, which, however, can be briefly broken by external stimuli Orientation is always possible Simple questions can be answered Guiding symptoms of the sopor Drowsiness to be broken by very strong external stimuli. Contact not adequately possible … Disorders of Consciousness: Somnolence, Sopor and Coma: Symptoms, Complaints, Signs

Disorders of Consciousness: Somnolence, Sopor and Coma: Therapy

Immediately call 911! (Call number 112) Securing vital functions according to ABC scheme (scheme of measures within the framework of ACLS (Advanced Cardiac Life Support)): A (“Airway”): clear the airway and keep it open. B (“Breathing”): ventilate C (“Circulation“): compression of the chest (thorax) , ie performing chest compressions (HDM). As far as possible neurological … Disorders of Consciousness: Somnolence, Sopor and Coma: Therapy