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