Emergencies: Altered Level of Consciousness — Emergency Medicine

Emergency Room · Clinical Specialties

How it begins

Un análisis exhaustivo y riguroso de los mecanismos fisiopatológicos, semiología, aproximación diagnóstica multimodal y estrategias de intervención crítica para el paciente con afectación aguda del nivel de alerta en el departamento de urgencias.

What it covers

1. Alteration of the Level of Consciousness
2. Anatomy and Physiology of Consciousness
3. · The Ascending Reticular Activating System (SARA)
4. · Neurotransmission Systems Alert Regulators
5. · The Cerebral Cortex and Functional Connectivity Networks
6. Definitions and Semiological Classification
7. · Qualitative States of Consciousness
8. · Clinical Syndromes of Dissociation of Consciousness
9. Epidemiology and Initial Approach in Emergencies
10. · Global Etiological Distribution
11. Pathophysiology of Diffuse Brain Dysfunction and ICH
12. · The Monro-Kellie Doctrine
13. · Autoregulation and Cerebral Perfusion Pressure (CPP)
14. · Types of Cerebral Edema
15. Structural Commas vs. Metabolic
16. · Mechanisms of Brain Herniation
17. · Diffuse Axonal Damage (DAD)
18. · Pathophysiology of Metabolic and Toxic Coma
19. Ion Channels and Neurotransmission in Coma
20. · The Excitotoxic Glutamate Cascade
21. · GABAergic hyperstimulation and Neurosteroids
22. · The Mitochondrial Energy Failure Hypothesis
23. Clinical Evaluation and Severity Scales
24. · The Glasgow Coma Scale (GCS) and its Evolution
25. · The FOUR Scale (Full Outline of UnResponsiveness)
26. · Respiratory Patterns and Their Injury Location Value
27. Neurological Examination of Coma in the Emergency Room
28. · 1. Detailed Pupillary Examination
29. · 2. Exploration of Brain Stem Reflexes
30. · 3. Pathological Motor Responses (Postures)
31. Etiological Diagnosis and Approach Algorithm
32. · Universal Mnemonics: AEIOU-TIPS
33. Complementary Tests and Neuroimaging
34. · 1. Simple Cranial Computed Tomography (CT)
35. · 2. Lumbar Puncture (LP) in Emergencies
36. · 3. Electroencephalography (EEG) in Emergencies
37. Initial and Life Support (ABCDE) in the Comatose Patient
38. · The Golden Rule: Protect the Airway (GCS ≤ 8)
39. · Control of Physiological Constants (Avoid Secondary Damage)
40. Surgical and Structural Management of Intracranial Hypertension
41. · Urgent Medical Strategies for ICP Reduction
42. · Indications for Emergency Neurosurgical Intervention
43. Directed Treatment of Metabolic and Toxic Causes
44. · 1. Severe Hepatic Encephalopathy (Grade III - IV)
45. · 2. Uremic Encephalopathy and Cardiorenal Syndrome
46. · 3. Diabetic Ketoacidosis (DKA) and Hyperosmolar State (HHS)
47. · 4. Specific Antidotes in Acute Poisoning
48. Brain Death and Coma Prognosis
49. · Definition and Absolute Prerequisites
50. · The Clinical Exploration of Brain Death
51. · Instrumental Confirmation Methods