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Coma Bp
1. MANAGEMENT OF UNCONSCIOUS PATIENT DR. B. PRAKASH. Prof. M.B. PRANESH DEPT. OF NEUROLOGY KG HOSPITAL AND POSTGRADUATE INSTITUTE, COIMBATORE – INDIA
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4. Eye opening 4 Spontaneous 3 To speech 2 To pain 1 None Best motor response 6 Obeying 5 Localizing pain 4 Withdrawal 3 Abnormal flexing 2 Extensor response 1 None GLASGOW COMA SCALE Best verbal response 5 Oriented 4 Confused conversation 3 Inappropriate words 2 Incomprehensible sounds 1 None USED MOSTLY FOR HEAD INJURY PATIENTS RATHER THAN STROKE (HEMIPLEGIA,APHASIA)
5. Algorhythm COMA Airway/?Intubate IV Line CFCD Tests-Eme History-Eme CBC, ESR Sugar,RFT ABG,Lytes CXR,ECG Ca,Mg, Toxic Scr’n TRAUMA CT Scan No Trauma Neu.Surg Stiff Neck CT Scan Normal SAH LP Meningitis Toxin Alc->Thiamine 100mg / 50% Dextose 50 ml Opiate -> Inj.Naloxone 0.4-0.8mg IV BenzDia ->Inj.Flumazenil 0.2-1 mg IV Others -> Stomach wash / Antidote / Sympt Supple CNS Exam Normal Lateralising Metabolic CT Scan