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[The comatose child].

B P Wagner1

  • 1Abteilung für pädiatrische Intensivbehandlung, Medizinische Universitäts-Kinderklinik, Inselspital, Bern. bendicht.wagner@insel.ch

Therapeutische Umschau. Revue Therapeutique
|September 3, 2005
PubMed
Summary
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Acute coma in children poses significant risks, requiring prompt evaluation and treatment of brain injury and vital sign instability. Early management focuses on airway control, cardiovascular support, and addressing immediate causes like hypoglycemia or seizures.

Area of Science:

  • Pediatric Neurology
  • Emergency Medicine

Context:

  • Acute coma in children presents a critical medical emergency.
  • High risk of cardiopulmonary compromise, direct brain injury, and cerebral herniation.

Purpose:

  • To outline the emergent evaluation and case-management of acute coma in pediatric patients.
  • To detail coma-specific examinations and immediate treatment strategies.

Summary:

  • Coma-specific evaluation includes the child-adapted Glasgow Coma Score (GCS) and brainstem function assessment.
  • Management involves treating hypoxic-ischemic insults, cardiovascular instability, and cerebral herniation.
  • Immediate interventions target hypoglycemia, meningitis, opioid overdose, and status epilepticus.

Impact:

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  • Facilitates timely and appropriate management of pediatric acute coma.
  • Aims to reduce mortality and morbidity associated with severe neurological impairment in children.
  • Guides healthcare professionals in diagnosing and treating the underlying causes of coma.