Coma

Question 1

Which two examinations are the most important in unconsious patients?

Answer 1

neuro

resp

Question 2

Which blood test is most important in unconsious patients?

Answer 2

glucose

Question 3

Which GCS scores indicate what?

Answer 3

Brain injury

minor 13-15, moderate 9-12, severe 3-8

Question 4

What are 3 ways you could apply painful stimuli?

Answer 4

pressure to fingertip, trapezius, supraorbital notch

Question 5

What are the 4 pathological/clinical categories for causes of LOC?

Answer 5

neuro
metabolic
diffuse physiological brain dysfunction (drugs/alcohol)
psychiatric/functional

Question 6

How would you treat heroin overdose?

Answer 6

Naloxone (should improve after 1-2 mins)

400 micrograms - 800 micrograms

Question 7

What is the triad of opiate overdose?

Answer 7

slowed RR, pinpoint pupils, unconsiousness

Question 8

What is the criteria for intubation and ventilation in head injury patients?

Answer 8

intubate all with GCS of 8 or less or requiring transfer to neuroscience unit
- if in coma (GCS of 8 or less)
- loss of protective laryngeal reflexes
ventilatory insufficinecy as judged by blood gases (o2 <13, co2 >6)
spontanouse hyperventilation (co2 <4), irregular respirations