Altered Level Of Consciousness: Evidence-Based Management In The Emergency Department.

Joo Lee Song, Vincent J Wang

Journal: Pediatric emergency medicine practice 2017;14(1):1-28

PMID: 28027458

Abstract

A child who presents to the emergency department with an altered level of consciousness can be clinically unstable and can pose a great diagnostic challenge. The emergency clinician must quickly develop a wide differential of possible etiologies in order to administer potentially life-saving medications or interventions. The history, physical examination, and appropriate diagnostic tests can aid greatly in rapidly narrowing the differential diagnosis. Once initial stabilization, workup, and first-line interventions are completed, most patients who present with unresolved or unidentified altered level of consciousness should be admitted for further evaluation and close monitoring. This issue provides a review of the etiologies of altered level of consciousness as well as guidance for the management and disposition of patients with this condition.

Address: Fellow, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA.; Professor of Pediatrics, Keck School of Medicine of the University of Southern California; Associate Division Head, Division of Emergency Medicine, Children's Hospital Los Angeles, Los Angeles, CA.

MeSH Terms: Arrhythmias, Cardiac, Brain Diseases, Brain Injuries, Carbon Monoxide Poisoning, Child, Consciousness Disorders, Diagnosis, Differential, Disease Management, Emergency Service, Hospital, Encephalitis, Epilepsy, Evidence-Based Emergency Medicine, Fever, Humans, Hypoglycemia, Hypothermia, Hypoxia, Meningitis, Pediatric Emergency Medicine, Poisoning, Shock, Stroke, Syncope, Water-Electrolyte Imbalance