Patient won’t wake up

 

Causes:

Drugs

·      Hypnotic (apply BIS)

·      Opioid (give naloxone)

·      Relaxant (TOF ratio)

Phys (ABG)

·      CO2

·      Acid-base

·      Temperature

·      Glucose

·      Sodium

Path

·      Stroke (CT brain)

·      Non-convulsive status epilepticus (EEG)

 

What to do:

Find and fix the cause

 

   -Examination

·      Respiration

·      GCS

·      Pupils

   -Investigations

·      ABG

·      CT brain

·      +/- EEG later

·      +/- formal bloods later
(rare metabolic/endocrine)

Disposition

·      ICU if still unconscious

Discussion

·      Family members

·      Home team

·      Neurology if indicated