ABC: open and maintain the airway, lay in recovery position, remove
false teeth if poorly fitting, insert oral/nasal airway, intubate if
necessary
100% oxygen + suction as required
IV access, take blood:
U+E, LFT, FBC, glucose (exclude hypoglycaemia)
Toxicology screen if indicated, anticonvulsant levels
Thiamine IV if alcoholism. Unless glucose known to be normal deliver.
Correct hypotension with fluids
Slow IV fluid bolus of
lorazepam
If seizures continue:
phenytoin
Last resort is general anaesthesia
Stroke
Airway: Put in recovery position. Refer to Speach and Language team to check swallowing.
Breathing: Deliver oxygen.
Circulation: IV access, and ensure hydration.
Measure and treat hypoglycaemia
Investigations: Urine sample
ECG (atrial fibrillation?)
Bloods: FBC, U+E, glucose, lipids, platelets, clotting (brain haemorrhage?), ESR
CXR. Carotid doppler. Consider echo heart.
CT: urgent if less than 3h or posterior circulation lesino, otherwise 3-5d
Treatment: Aspirin 300mg, consider thrombolysis.
Treat pressure sores, give NG tube and catheterise if necessary. DVT prophylaxis.