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Updated: Sep 29, 2026

SECONDs Administration Guidelines: A Fast Tool to Assess Consciousness in Brain-injured Patients
Published on: February 6, 2021
[ABC--DER TIP--STIMMT. Primary assessment of consciousness disorders]
1Zentrale Notfall Aufnahme, Kantonsspital St. Gallen.
Abstract:
A unconscious patient produces fear for laymen and uncertainty for professionals. Because acute changes in consciousness, that means changes in alertness or thinking, are challenges for every physician. Therefore the assessment of a unconscious patient demand a structural action. In this paper a reliable procedure is proposed in three steps. As a mnemonic serves the sentence "ABC (1st step)--DER TIP (2nd step)--STIMMT (3rd step)". The first step contains the ABC, which is usual in emergency medicine. In the second step neurological and other disabilities are noticed. An in the third step one tries, related to the findings from step one and two as well as from further examinations (CCT, lumbal puncture, lab-examines, ...), to find potential reasons for the unconsciousness of a patient.
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