Archive:Coma: Difference between revisions
wikademia>Koppertone New page: ==Causes of Coma== *One Mneumonic is “GAMETIMES”: *G glucose (hyperosmolar or hypoglycemia) *A anoxia, acidosis, alcohol’s *M medications (one of the most common causes) *... |
wikademia>Wikademia m moved Coma to Archive:Coma |
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*One Mneumonic is “GAMETIMES”: | *One Mneumonic is “GAMETIMES”: | ||
*G | *'''G ''' glucose (hyperosmolar or hypoglycemia) | ||
*A anoxia, acidosis, alcohol’s | *'''A''' anoxia, acidosis, alcohol’s | ||
*M | *'''M ''' medications (one of the most common causes) | ||
*E electrolytes, “environment” (hypothermia) | *'''E''' electrolytes, “environment” (hypothermia) | ||
*T | *'''T ''' tumor, toxins, trauma | ||
*I infections (e.g. meningitis, encephalitis, sepsis) | *'''I''' infections (e.g. meningitis, encephalitis, sepsis) | ||
*M | *'''M ''' Metabolic, adrenal, renal, hepatic, (diabetes listed above) | ||
*E epilepsy | *'''E''' epilepsy | ||
*S stroke, (P)sychiatric pseudocoma | *'''S''' stroke, (P)sychiatric pseudocoma | ||
{{ntnes}} | |||
==The Glasgow Coma Scale== | ==The Glasgow Coma Scale== | ||
{| | {| border="1" cellpadding="2" cellspacing="0" | ||
|- | |- | ||
|Eye opening | |'''Eye opening''' | ||
|Best Motor Response | |'''Best Motor Response''' | ||
|Verbal Response | |'''Verbal Response''' | ||
|- | |- | ||
|Spontaneous 4 | |Spontaneous 4 | ||
| Line 43: | Line 43: | ||
|No response 1 | |No response 1 | ||
| | | | ||
|} | |||
==Neurological Exam== | |||
{| border="1" cellpadding="2" cellspacing="0" | |||
|- | |||
|'''Function''' | |||
|'''Normal''' | |||
|[[wikipedia:Diencephalon|'''Diencephalon''']] | |||
|[[wikipedia:Midbrain|'''Midbrain''']] | |||
|[[wikipedia:Pons|'''Pons''']] | |||
|- | |||
|'''Respiration''' | |||
|Normal | |||
|Cheyne-Stokes | |||
|Regular, hyperventilation | |||
|Irregular, erratic | |||
|- | |||
|'''Pupil Size and Response to light''' | |||
|Normal | |||
|Small, Reactive | |||
|Mid-position, fixed | |||
|Pinpoint Reactive | |||
|- | |||
|'''Oculovestibular Reflex''' | |||
|Suppressed | |||
|Constant (tonic) deviation | |||
|Dysconjugate gaze | |||
|No response | |||
|- | |- | ||
} | |'''Motor response to pain''' | ||
|Appropriate | |||
|Decorticate | |||
(arms flexor response) | |||
|Decerebrate (all extensor response) | |||
|No response | |||
|} | |||
==Other OSCE Modules== | |||
{{OSCE2}} | |||
[[Category: Emergency Medicine]][[Category:OSCE]][[Category: Clinical Skills]][[Category: Neurology]] | |||
Latest revision as of 16:14, 12 June 2009
Causes of Coma
- One Mneumonic is “GAMETIMES”:
- G glucose (hyperosmolar or hypoglycemia)
- A anoxia, acidosis, alcohol’s
- M medications (one of the most common causes)
- E electrolytes, “environment” (hypothermia)
- T tumor, toxins, trauma
- I infections (e.g. meningitis, encephalitis, sepsis)
- M Metabolic, adrenal, renal, hepatic, (diabetes listed above)
- E epilepsy
- S stroke, (P)sychiatric pseudocoma
The Glasgow Coma Scale
| Eye opening | Best Motor Response | Verbal Response |
| Spontaneous 4 | Follows commands 6 | Orientated 5 |
| To speech 3 | Localizes to painful stimuli 5 | Confused conversation 4 |
| To pain 2 | Withdrawal from pain 4 | Inappropriate words 3 |
| No response 1 | Flexion reflex response to pain 3 | Incomprehensible sounds 2 |
| Extension reflex response to pain 2 | No response 1 | |
| No response 1 |
Neurological Exam
| Function | Normal | Diencephalon | Midbrain | Pons |
| Respiration | Normal | Cheyne-Stokes | Regular, hyperventilation | Irregular, erratic |
| Pupil Size and Response to light | Normal | Small, Reactive | Mid-position, fixed | Pinpoint Reactive |
| Oculovestibular Reflex | Suppressed | Constant (tonic) deviation | Dysconjugate gaze | No response |
| Motor response to pain | Appropriate | Decorticate
(arms flexor response) |
Decerebrate (all extensor response) | No response |
Other OSCE Modules
Acute Confusion - Acute Coronary Syndrome Orders - Anemia - Arterial Blood Gasses - Asthma - Blood Pressure - Chest pain - Chest XRay - CHF - Coma - COPD - Cranial Nerves - Diabetic History - Diabetic Foot - Dysphagia - EKGs - Gallbladder and Liver - Liver Disease - Gait and Balance - Headache - Hematemesis - Hypertension - Jugular Venous Pulses - Knee Exam - Lymph Nodes - Community Acquired Pneumonia - Parkinson Disease - Peripheral Arterial Insufficiency - Pneumonia Examination - Precordial Exam - STD's - Spleen - Swollen Leg Exam - Thyroid Exam - Upper vs Lower Motor Neuron Lesions - Urinary Incontinence