confusion/low GCS

Question 1

confusion/low GCS DDX

complications

Answer 1

dementia
delirium
drugs (opiates)
sepsis
electrolyte abnormalities
neuro pathology (cerebral haemorrhage)
resp acidosis - if co2 retainer
hypoglycaemia

complications:
falls, reduced GCS, airway compromise

Question 2

confusion/low GCS durine call

Answer 2

background
pre morbid state
obs
drugs given

ask for: cap glucose and ketones

Question 3

confusion/low GCS Hx and exam

Answer 3

full systems review
collateral

check drug chart - opiates
obs + cap glucose
GCS + pupils + orientation
sepsis signs = cap refill, skin temp, pulse
infection sources: multi system exam, surgical wounds, drains, lines

Question 4

confusion/low GCS Ix

Answer 4

bloods: calcium, WCC,CRP
VBG lactate
ABG if resp (CO2 retaining)
urine dip
sepsis 6
CT head if neuro

Question 5

confusion/low GCS Rx

Answer 5

Rx cause (antb if infection)
airway placement if GCS <8
suspend/reverse drugs - opiates