Initial assessment and management of coma in pediatric ...
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Initial assessment and management of coma in pediatric population.

Airway - is it secure? 
Breathing — is respiratory effort sufficient? 
Circulation - treat shock 
Disability — check blood glucose 
 - AVPU or Glasgow Coma Scale 
Exposure - e.g. look for meningococcal purpuric rash 

Examination 
 - Is there raised intracranial pressure — abnormal breathing, posture, 

pupils, fundi (papilloedema or retinal haemorrhages)? 
 - Bradycardia and hypertension suggest impending brain stem herniation 

Treat the treatable: 
 - hypoglycaemia 
 - poisoning 
 - diabetes mellitus 
 - septicaemia/meningitis 
 - herpes simplex encephalitis 

Intubate and ventilate if necessary, transfer to paediatric/neurosurgical 

intensive care unit 


#Assessment #Coma #Pediatrics #Peds #ABCs #CriticalCare #Diagnosis
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