What are the variations within the spectrum altered conscious state?
- Conscious
- Confusion and disorientation
- Lethargy
- Stupor
- Vegetative state
- Coma
what does the acronym AEIOU TIPS stand for?
A - alcohol
E - epilepsy, encephalitis, electrolyte imbalances, endocrine disorders
I - Insulin, Ischaemia
O - Overdose, decreased Oxygen
U - Uremia
T - Trauma, temperature
I - Infection
P - Poisons
S - Shock, Stroke, sever sepsis
What is another word for flexion in motor gcs?
decorticate
What is another word for extension in motor gcs?
decerebrate
Disorientation occurs to 4 stages… what are they?
First to time
Second to place
Then short term memory
Then loss of recognition of self
What is lethargy?
a state resembling profound slumber.
Lethargic patient can only be aroused with moderate external stimuli
What is stupor?
deep sleep or unresponsiveness
What is a vegetative state?
no evidence of self awareness to verbal or tactile stimuli
What is a coma?
pt is unresponsive to all stimuli including pain
What are some effects of alcohol?
- resp depression
- irritates oesophagus and stomach
- increase vomit risk
- gag reflex depression
- aspiration
- vasodilation of peripheral blood vessels which can leaded to hypothermia
- hypotension
what are the stages of alcohol concentration?
- 05 - feeling of wellbeing
- 05 - 0.08 - risky state
- 08-0.15 - Dangerous state
- 15-0.30 - Stupor
> 0.3 - death
What is epilepsy?
Disruption of normal electrochemical activity of the brain resulting in seizures.
Only when tendency to have more than one seizure is epilepsy diagnosed
define epilepsy and seizures in general?
paroxysmal motor , sensory and cognitive manifestations from a collection of neurons
What are the types of epileptic seizures?
Partial:
- simple partial
- complex partial
Generalised:
- Absent
- Myoclonic
- Tonic clonic
What is a simple partial seizure?
- no impairement to consciousness
- can present with localised motor mvmt
- can present with sensory disturbance
- can present with diaphoresis, hypotension, pupillary changes
What is a simple complex seizure?
- impairs consciousness
- start localised and can become more generalised
- accompanied by unconscious behaviours such as lip smacking, patting, grimacing etc
- > can be Post Ictal State (After seizure)
- confusion
- deja vu
- unfamiliar with surrounding
- detached
- depersonalised
What is a generalised absent seizure?
- non convulsive
- disturbance in consciousness
- limited signs and symptoms
- mainly occurs in children
What is a Myoclonic seizure?
- brief involuntary muscle contractions
- Bilateral rigid violent contractions of muscles
- Jolting
- Impaired conscious state during
What is a tonic clonic seizure?
- most common
- sharp tonic contraction with extension of extremities and immediate loss of consciousness
- Incontinence
- Cyanosis - constriction of airways
- followed by Clonic phase (jerking)
- bilateral contraction and reaction of extremities
- deviation of eyes
- last 60-90 seconds
What is Encephalopathy?
- brain disease, damage or malfunction
- main symptom is altered conscious state
What can cause Encephalopathy?
- infection
- anoxia
- brain trauma
- alcohol
- liver failure
- metabolic disease
- toxic chemicals
In electrolyte abnormalities, what is Hypernatraemia?
Sodium levels >145mEq/L
- dehydration… more sodium in ECF means less in cells
What are signs and symptoms of hypernatraemia?
- Aliguria
- Polydipsia
- Dri skin
- Tachycardic
- Decrease BP
- Headache
What is Hyponatraemia?
Excessive loss of sodium or excessive water intake
Plasma sodium <135mEq/L
