Acute Medicine | Neurology | Dealing with the unconscious patient

Dealing with the Unconscious Patient
Session Overview
Description
This session focuses on a practical approach to managing an unconscious patient.

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

• Adopt a structured approach to managing the unconscious patient
• Identify important clinical diagnostic clues

Coma is a state of:
• Total unawareness of both self and external surroundings
• No meaningful response to external stimuli

Consciousness relies on the integrity of the bilateral cerebral hemispheres and reticular activating system in the brainstem [1].

Coma results from impairment of both cerebral hemispheres and/or the ascending reticular activating system.

Severity varies from a state of coma to varying degrees of altered consciousness. Terms such as 'stupor' and 'drowsiness' are best avoided.

'Persistent vegetative state' refers to a comatose state in which there is sparing of brainstem and diencephalon function with preserved autonomic and motor reflexes and sleep-wake cycles. The term 'minimally conscious state' is used if some awareness is preserved.