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New Onset Coma

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Medical Emergency - New Onset Coma is an immediate reason to worry, start crying, and perhaps call a real doctor!

Causes

There are three main categories that cause new onset coma: metabolic, infective and neurological:

Metabolic causes of new coma

Infective causes of new coma

Neurological causes of new coma

Management

  1. First things first: ABC, then check fluids and shock.
  2. Check blood glucose and if its low, give them 50mL of 50% dextrose immediately! This can prevent brain damage. If its high, treat the shock, then give them some insulin.
  3. IV thiamine if there's any hint of Wernicke's Encephalopathy, ataxia, eye muscle problems and confusion.
  4. IV nalaxone if heroin overdose.
  5. IV flumazenil if benzodiazepine overdose, causing respiratory depression.