CanadiEM Podcasts: CRACKCast, ClerkCast, CarmsCast, First Year Diaries CRACKCast E016 - Altered Level of Consciousness and Coma
Apr 12, 2016
A rapid tour through causes of altered consciousness using memorable mnemonics like DIMS and AEIOU-TIPS. Clear reviews of adult and pediatric GCS scoring and documentation. Practical demos of brainstem reflex testing, including doll's eyes and cold calorics. A concise checklist for initial assessment and age-specific common causes.
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Consciousness Splits Into Arousal And Cognition
- Consciousness has two separable components: arousal and cognition. The ascending reticular activating system in the brainstem controls arousal while bilateral cerebral cortices govern cognition like orientation and memory.
Always Run A Mnemonic For Coma Causes
- Use a systematic mnemonic to avoid missing causes of altered LOC like DIMS (Drugs, Infection, Metabolic, Structural) with added Environmental causes. The DIMS list highlights opiates, beta blockers, CO, cyanide, and intracranial catastrophes.
Use OBs 5Cs For Critical Toxin Rapid Recall
- Memorize focused toxin checklists like OBs 5Cs for critical overdoses: Opiates, Beta blockers, Carbon monoxide, Cyanide, Calcium channel blockers, Cyclic antidepressants, Cardiac glycosides. These target high-risk reversible toxic causes of coma.