Unconscious Patient

Question 1

What are the main causes of coma?

Answer 1

Vascular
Infection/inflammatory 
Trauma
Autoimmune 
Metabolic 
Inherited/iatrogenic 
Neoplasm

Question 2

Treatment of airway obstruction

Answer 2

Airway manoeuvres - head tilt chin lift  or jaw thrust 
Adjuncts 
- nasopharyngeal tube 
- oropharyngeal tube 
Suction 
Finger sweep

Question 3

How do you assess breathing

Answer 3

Oxygen saturations - high flow oxygen
Expansion
Respiratory rate
Respiratory effort

Question 4

How do you assess circulation?

Answer 4

Heart rate
Blood Pressure - IV access, bloods and fluids
Capillary refill
ECG

Question 5

How to assess disability.

Answer 5

GCS
Pupils - both equal and reactive 
Lateralising signs 
Reflexes
Plantar responses - upper motor neurone 
BM

Question 6

How to assess exposure.

Answer 6

Temperature
External signs of trauma
Rash - meningitis?
Neck stiffness

Question 7

ECG changes in hyperkalaemia

Answer 7

Wide QRS
Tall tented T waves
Prolonged PR interval
Loss of P wave

Question 8

Management of hyperkalaemia

Answer 8

Venous sample to confirm levels
Reverse the cause
Insulin/glucose
Salbutamol nebs

Question 9

Treatment of status epilepticus

Answer 9

Benzodiazepines
Look for cause
IV anti-epileptics
Consider ITU

Question 10

Causes of thunderclap headache

Answer 10

SAH (aneurysmal haemorrhage)
Intracerebral haemorrhage
Non-haemorrhagic
Primary