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Emergency management
ABC
Coma
Shock
Cardiology
Respiratory
GI
Neuro
Metabolic and Poison
Oncology
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Coma Management

  1. ABC
  2. Oxygen, IV access. Consider intubation if GCS < 8
  3. Stabilize cervical spine
  4. Blood glucose (hypoglycaemia)
  5. Control seizures
  6. Consider IV glucose, thiamine (withdrawel), naloxone or flumazenil
  7. Brief ex, take hx
  8. Investigations: ABG, FBC, U+E, LFT, ESR, CRP.
    Ethanol, toxic screen, drug levels
    Blood cultures, urine cultures, consider malaria in traveller
    CXR
  9. Reassess and plan further investgatins

Causes

Metabolic
  • Drugs, poisoning
  • Hypo/hyperglycaemia
  • Septicaemia
  • Hypothermia
Neurological
  • Trauma
  • Meningitis/encephalitis
  • Tumour
  • Vascular
  • Epilepsy
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