ICU learning pathway | Causes and investigation of Coma

Causes and Investigation of Coma
Session Overview
Description
An overview of the causes, investigation and immediate management of the comatose patient.

By the end of this session you will be able to:

• Explain the causes of coma
• Explain how investigation and management should proceed simultaneously to prevent secondary injury
• Evaluate comatose patients through relevant history and investigation, and formulate a differential diagnosis
• Identify the indications for and basic interpretation of radiological investigations
• Define the following for lumbar puncture: Indications, contraindications, complications, the tests to request it and how to interpret the results

Before commencing this session you should complete:

• Module 02/Preoperative assessment/Investigations and interpretation/Simple CT and MRI Scans 1 (001-0150)
• Module 03/Unconscious patient/General principles/Assessment, Differential Diagnosis and Investigation (001-0309)
• Module 03/Unconscious patient/General principles/Examination of the unconscious patient (AVPU, GCS) (001-0342)

Anaesthetists are commonly asked to assist in the management of comatose patients. As with other emergency situations, assessment and management must run concurrently.

In an emergency situation, comatose patients are at high risk of sustaining secondary insults. Timing is critical, and simple interventions can prevent this happening and increase the chances of a positive outcome.

This session will firstly outline the possible causes of a reduced level of consciousness. Secondly, it will demonstrate a logical system to investigate the comatose patient. Finally, it will assess your understanding of the learning points through a self assessment section.