意识受损的急性发作意识受损的急性发作
Tobias Weiglein1, Markus Zimmermann, Wolf-Dirk Niesen
1Emergency Department, Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich; Department of Medicine III, Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich; Interdisciplinary Emergency Department, University Medical Center Regensburg, Regensburg; Department of Neurology, University Medical Center Freiburg, Freiburg; Kinderklinik und Kinderpoliklinik im Dr von Hauner Children's Hospital, Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich; Department of Neurology, Hospital of the Ludwig-Maximilians-University (LMU) Munich, Munich.
意识受损的急性发作是一种具有高死亡率的医疗紧急情况. 快速识别红旗和立即治疗对于更好的患者结果至关重要.
科学领域:
- 神经学 神经学
- 紧急医疗 紧急医疗
背景情况:
- 意识受损的急性发作具有高死亡率 (10%) 和广泛的差异诊断.
- 超过三分之一的患者患有多种潜在疾病.
- 结构化的急救部门方法是必不可少的.
研究的目的:
- 描述一种结构化的方法来管理急性意识损伤患者在急诊室的管理.
- 要突出关键的诊断和管理策略.
主要方法:
- 有关文章的选择性PubMed搜索.
- 审查AWMF关于意识受损常见原因的指南.
主要成果:
- 意识障碍被分为定量或定性.
- 主要的神经病因占45-50%的病例;代谢/传染病因~20%.
- 关键的"红旗"包括超急性发作,瞳孔变化,焦点缺陷,脑膜炎,头痛和生命体征异常. 最初的管理遵循ABCDE方案.
结论:
- 意识受损的急性发作是一种医疗紧急情况,需要立即识别和治疗.
- 患有严重,新发病,不确定的意识损伤,状态,缺失反射或新出现的神经缺陷的患者需要进入复苏室.
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