Work Up for Coma

Question 1

What emergency investigations should you consider in this presentation?
Coma, respiratory failure, shock, hypoglycaemia.

Answer 1

1. ABG to assess oxygenation and hypercapnia
2. GCS equal or less than 8 - anaesthetics for intubation
3. Consider IV pabrinex in history of alcohol and no low CBG

Question 2

What is the immediate management plan for this presentation?

Coma, core temperature below 34 degrees (hypothermia).

Answer 2

1. Rewarm and check TFTs

2. Give IV hydrocortisone and liothyronine if myxoedema coma

Question 3

What should you give in opioid toxicity?

Answer 3

Naloxone

Question 4

What signs should you look for in this presentation?

Coma, GCS below 8, head injury, headache.

Answer 4

Possible intracranial lesion:

Focal neurology, unilateral pupil abnormality, upgoing plantars.