Background: Disturbances of consciousness are frequent pediatric emergencies. Aims: This article describes the principles of emergency care of consciousness disturbance in children. The article is based on clinical guidelines with broad implementation. Results and discussion: If a child loses consciousness, the initial treatment consists of ensuring a reliable airway and maintaining adequate ventilation, oxygenation and blood pressure (ABC rule: airway, breathing, circulation). The severity of unconsciousness must be quantified by scoring systems, e.g. the Glasgow coma scale or the AVPU scale (alert, voice, pain or unresponsive). The patient's history and further clinical abnormalities (e.g. fever, meningism and focal signs) are crucial for the next diagnostic step including urgent neuroimaging and lumbar puncture. If a central nervous system (CNS) infection is suspected, anti-infective treatment must not be delayed. In unconscious patients with ventriculoperitoneal shunt systems a pediatric neurosurgeon has to be contacted in order to rule out shunt insufficiency.
|Translated title of the contribution||Consciousness disturbances in children: An interdisciplinary challenge|
|Journal||Monatsschrift fur Kinderheilkunde|
|Number of pages||9|
|Publication status||Published - 08.2013|
Research Areas and Centers
- Academic Focus: Center for Brain, Behavior and Metabolism (CBBM)