New Onset Coma: Difference between revisions
Jump to navigation
Jump to search
No edit summary |
|||
| (11 intermediate revisions by the same user not shown) | |||
| Line 1: | Line 1: | ||
__NOTOC__ | |||
[[image:punkcoma.jpg|right|thumb|300px]] | |||
[[image:emergency.gif|left]]'''[[Medical Emergency]] - [[New Onset Coma]] is an immediate reason to worry, start crying, and perhaps call a real doctor!''' | [[image:emergency.gif|left]]'''[[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]]: | There are three main categories that cause new onset coma: [[metabolic]], [[infective]] and [[neurological]]: | ||
| Line 15: | Line 17: | ||
*'''Vascular''' - A [[stroke]] or a [[haemorrhagic bleed]]. | *'''Vascular''' - A [[stroke]] or a [[haemorrhagic bleed]]. | ||
==Management== | |||
#First things first: [[ABC]], then check fluids and [[shock]]. | |||
#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]]. | |||
#'''IV thiamine''' if there's any hint of [[Wernicke's Encephalopathy]], [[ataxia]], [[visual disturbance|eye muscle problems]] and [[confusion]]. | |||
#'''IV nalaxone''' if heroin overdose. | |||
#'''IV flumazenil''' if benzodiazepine overdose, causing [[respiratory]] depression. | |||
Latest revision as of 15:19, 10 December 2009
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
- Drug - Alcohol abuse, drug abuse and carbon monoxide poisoning are all good. Wernicke's Encephalopathy can also be caused.
- Sugar - Low sugar (hypoglycaemia), or high sugar (ketoacidosis) both cause coma in diabetics.
Infective causes of new coma
Neurological causes of new coma
- Trauma - Head injury is a good one for putting you in a coma.
- Tumour - A brain tumour in the wrong place can cause a coma.
- Vascular - A stroke or a haemorrhagic bleed.
Management
- First things first: ABC, then check fluids and shock.
- 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.
- IV thiamine if there's any hint of Wernicke's Encephalopathy, ataxia, eye muscle problems and confusion.
- IV nalaxone if heroin overdose.
- IV flumazenil if benzodiazepine overdose, causing respiratory depression.