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Coma Algorithm

Aka: Coma Algorithm, Approach to Coma

See Also
1. Altered Level of Consciousness
2. ALOC Causes
3. Coma Exam
Psychogenic Coma
1. Electroencephalogram (EEG)
2. Amytal interview
Physiologic Coma: Nonfocal exam
1. Evaluate laboratory data and correct abnormalities
2. If labs Normal then evaluate as with Focal exam below
Physiologic Coma: Focal exam
1. Step 1: Obtain CT Head, If Abnormal:
  1. Ischemic CVA: Supportive care
  2. Hemorrhagic CVA, Tumor or brain Abscess
    1. Herniation
      1. Neurosurgical Consultation stat
      2. Decadron
      3. Mannitol
      4. Hyperventilation
    2. No Herniation
      1. Supportive care
      2. Neurosurgical Consultation
2. Step 2: Obtain Lumbar Puncture, If Abnormal
  1. Meningitis
    1. Antibiotics
  2. Subarachnoid Hemorrhage
    1. Neurosurgical Consultation
3. Step 3: Unclear etiology (above testing normal)
  1. Etiologies
    1. Brain Stem infarct
    2. Drug overdose
    3. Complex partial Status Epilepticus
  2. Evaluation
    1. Electroencephalogram (EEG)
    2. MRI Head
  3. Management
    1. Supportive Care

Family Practice Notebook

Patients should address specific medical concerns with their physicians.

Although access to this page is not restricted, the information found here is intended for use by medical providers.

This page was written by Scott Moses, MD, last revised on 10/21/2007 and last published on 5/17/2012.

This is one of 5740 pages in the Family Practice Notebook