Initial approach to the patient with impaired consciousness

Patients presenting with impaired consciousness are often challenging to diagnose and treat. Etiologies are multiple and varied. Obtaining an accurate history and physical exam is often difficult with the altered patient. It is essential for the physician initially evaluating the patient to have a prioritized, systematic approach. The primary goals are to stabilize the patient, rapidly recognize and treat reversible causes, and disposition the patient appropriately to avoid potential morbidity and mortality.