Initial assessment and management of coma in pediatric population. Airway - is it secure? Breathing — is respiratory effort sufficient? Circulation - treat shock Disability — check blood glucose - AVPU or Glasgow Coma Scale Exposure - e.g. look for meningococcal purpuric rash Examination - Is there raised intracranial pressure — abnormal breathing, posture, pupils, fundi (papilloedema or retinal haemorrhages)? - Bradycardia and hypertension suggest impending brain stem herniation Treat the treatable: - hypoglycaemia - poisoning - diabetes mellitus - septicaemia/meningitis - herpes simplex encephalitis Intubate and ventilate if necessary, transfer to paediatric/neurosurgical intensive care unit #Assessment #Coma #Pediatrics #Peds #ABCs #CriticalCare #Diagnosis
