What do you need to maintain consciousness? Flashcards
What is consciousness?
A state of awareness of self and environment
What is unconsciousness?
Loss of awareness of self and environment
What is coma
State of unrousable unresponsiveness in which there is no coordinated response to external stimuli or internal need
What is the Glasgow Coma Scale used for?
Glasgow Coma Scale is the most widely used scale for depth of unconsciousness
What are the ranges in Glasgow Coma scale?
Eye opening (E) = 1-4 Verbal response (V) = 1-5 Motor response (M) = 1 - 6
Maximum score is 15 Minimum sore is 3 Eye Opening response: 4. Spontaneously 3. To speech 2. To pain 1. No response
Verbal Response
- Oriented to time, person and place
- Confused
- Inappropriate words
- Incomprehensible sounds
- No response
Motor Response
- Obeys command
- Moves to localised pain
- Flex to withdraw from pain
- Abnormal flexion
- Abnormal extension
- No response
What is classed as coma in the Glasgow Coma scale
3-8
Requirements for consciousness
Normal brain structure and function Blood pressure (MAP) Normal PaCO2 and Pa02 [Hb] [Glucose] Na, Mg2+, Ca2+ Core temperature Renal, adrenal and hepatic function
What are the three main ways of losing consciousness?
Syncope: Transient brain hypoxia resulting in loss consciousness or a
near loss of consciousness (presyncope)
Seizure: Episode of uncontrolled electrical activity of the brain
Psychogenic: Psychological, no physical/organic cause
What are causes of syncope?
Arrhythmias Structural disorders of the heart Baroreceptor reflex related Posture related (Orthostatic) Others
What is orthostatic hypertension?
fainting after standing
What do you do if you suspect orthostatic hypertension?
Fainting shortly after standing. Measure blood pressure lying and standing up, fall of 20/10 mmHg is significant
What are precipitants of vasovagal syncope?
Feeling hot and lightheaded Nausea Vomiting Tunnel vision Voices seem distant Face looks very pale
What is happening in the body during vasovagal syncope?
Loss of skeletal muscle tone, goes limp Bradycardic due to increase vagal tone Hypotensive due to vasodilatation May have some jerking movements Incontinence of urine sometimes Tongue biting unusual
What is happening in the body after vasovagal syncope?
Rapid return of consciousness on lying flat (<1 minute)
May be confused for a minute or two
May feel malaise for a while afterwards
What are pseudogenic causes of collapse?
Pseudoseizure
non-epileptic
attack disorder NEAD
Pseudosyncope
