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3.4.1 - Decreased Consciousness

from Section 3.4 - Neurological Impairment and Injury

Published online by Cambridge University Press:  27 July 2023

By
Chris Whitehead  and
Ian Tweedie
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Initial resuscitation is key to improving outcome.

  2. 2. Breaking down the Glasgow Coma Score into sub-scores provides additional information to the total score.

  3. 3. Causes of impaired consciousness can be broadly divided into structural and diffuse aetiologies.

  4. 4. A structured approach can aid rapid assessment and confirmation of the diagnosis.

  5. 5. Accurate prognostication can take time and may require extensive investigation.

Keywords

consciousness disordersGlasgow Coma Scoreresuscitation
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 177 - 180
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

Cadena, R, Sarwal, A. Emergency neurological life support: approach to the patient with coma. Neurocrit Care 2017;27(Suppl 1):74–81.CrossRefGoogle Scholar
Edlow, JA, Rabenstien, A, Traub, SJ, Wijdicks, EFM. Diagnosis of reversible causes of coma. Lancet 2014;384:2064–76.CrossRefGoogle ScholarPubMed
Farling, P, Andrews, PJD, Cruickshank, S, et al. Recommendations for the safe transfer of patients with brain injury. London: Association of Anaesthetists of Great Britain & Ireland; 2006.CrossRefGoogle Scholar
Royal College of Physicians and Surgeons of Glasgow. The Glasgow structured approach to assessment of the Glasgow Coma Scale. www.glasgowcomascale.orgGoogle Scholar
Souter, MJ, Blissitt, PA, Blosser, S, et al. Recommendations for the critical care management of devastating brain injury: prognostication, psychosocial, and ethical management. Neurocrit Care 2015;23:4–13.CrossRefGoogle ScholarPubMed

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