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Coma Exam

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61. Prediction of blunt traumatic injuries and hospital admission based on history and physical exam Full Text available with Trip Pro

and for appropriate admission triage decisions.Using only their history and physical exam, and prior to any imaging studies, three (3) experienced trauma surgeons, with a combined Level 1 trauma experience of over 50 years, predicted injuries in patients with an initial GCS (Glasgow Coma Score) of 14-15. Additionally, ED disposition (ICU, floor, discharge to home) was also predicted. These predictions were compared to actual patient dispositions and to blunt injuries documented at discharge.A total of 101 (...) Prediction of blunt traumatic injuries and hospital admission based on history and physical exam We evaluated the ability of experienced trauma surgeons to accurately predict specific blunt injuries, as well as patient disposition from the emergency department (ED), based only on the initial clinical evaluation and prior to any imaging studies. It would be hypothesized that experienced trauma surgeons' initial clinical evaluation is accurate for excluding life-threatening blunt injuries

2016 World journal of emergency surgery : WJES

62. Accuracy of the Abdominal Examination for Identifying Children with Blunt Intra-Abdominal Injuries. (Abstract)

Accuracy of the Abdominal Examination for Identifying Children with Blunt Intra-Abdominal Injuries. To determine the accuracy of complaints of abdominal pain and findings of abdominal tenderness for identifying children with intra-abdominal injury (IAI) stratified by Glasgow Coma Scale (GCS) score.This was a prospective, multicenter observational study of children with blunt torso trauma and a GCS score ≥13. We calculated the sensitivity of abdominal findings for IAI with 95% CI stratified (...) by GCS score. We examined the association of isolated abdominal pain or tenderness with IAI and that undergoing acute intervention (therapeutic laparotomy, angiographic embolization, blood transfusion, or ≥2 nights of intravenous fluid therapy).Among the 12 044 patients evaluated, 11 277 (94%) had a GCS score of ≥13 and were included in this analysis. Sensitivity of abdominal pain for IAI was 79% (95% CI, 76%-83%) for patients with a GCS score of 15, 51% (95% CI, 37%-65%) for patients with a GCS

2014 Journal of Pediatrics

63. Neurological examination of critically ill patients: a pragmatic approach. Report of an ESICM expert panel. (Abstract)

Neurological examination of critically ill patients: a pragmatic approach. Report of an ESICM expert panel. Many patients admitted to the intensive care unit (ICU) have pre-existing or acquired neurological disorders which significantly affect their short-term and long-term outcomes. The ESICM Neuro Intensive Care Section convened an expert panel to establish a pragmatic approach to neurological examination (NE) of the critically ill patient.The group conducted a comprehensive review (...) of published studies on the NE of patients with coma, delirium, seizures and neuromuscular weakness in critically ill patients. Quality of data was rated as high, moderate, low, or very low, and final recommendations as strong, weak, or best practice.The group made the following recommendations: (1) NE should be performed in all patients admitted to ICUs; (2) NE should include an assessment of consciousness and cognition, brainstem function, and motor function; (3) sedation should be managed to maximize

2014 Intensive Care Medicine

64. Diverse effects of hypothermia therapy in patients with severe traumatic brain injury based on the CT classification of the Traumatic Coma Data Bank. Full Text available with Trip Pro

of the treatment were reexamined based on a secondary analysis of the BHYPO trial in 135 patients (88 treated with therapeutic hypothermia and 47 with fever control). This analysis was performed to examine clinical outcomes according to the CT classification of the Traumatic Coma Data Bank on admission. Clinical outcomes were evaluated with the Glasgow Outcome Scale and mortality at 6 months after injury. Good recovery and moderate disability were defined as favorable outcomes. Favorable outcomes in young (...) Diverse effects of hypothermia therapy in patients with severe traumatic brain injury based on the CT classification of the Traumatic Coma Data Bank. A multicenter randomized controlled trial of patients with severe traumatic brain injury who received therapeutic hypothermia or fever control was performed from 2002 to 2008 in Japan (BHYPO). There was no difference in the therapeutic effect on traumatic brain injury between the two groups. The efficacy of hypothermia treatment and the objective

2014 Journal of neurotrauma Controlled trial quality: uncertain

65. The Effect of Age on Glasgow Coma Scale Score in Patients With Traumatic Brain Injury. Full Text available with Trip Pro

The Effect of Age on Glasgow Coma Scale Score in Patients With Traumatic Brain Injury. The Glasgow Coma Scale (GCS) is used frequently to define the extent of neurologic injury in patients with a traumatic brain injury (TBI). Whether age affects the predictive ability of the GCS for severity of TBI (determined by the Abbreviated Injury Scale [AIS] score) remains unknown.To investigate the effect of age on the association between the GCS and anatomic TBI severity.We examined all patients (...) with a TBI, defined by diagnostic codes 850 to 854 from the International Classification of Diseases, Ninth Revision, Clinical Modification, who were admitted to 2 level I trauma centers from January 1, 2008, through December 31, 2012.We compared elderly (≥65 years) and younger (18-64 years) adults with TBI.We examined differences by age in GCS category (defined by emergency department GCS as severe [3-8], moderate [9-12], or mild [13-15]) at each level of TBI severity (head AIS score, 1 [minor] to 5

2014 JAMA surgery

66. Special Imaging Technique to Aid in the Diagnosis of Patients in Coma After Cardiac Arrest

Death Procedure: Computed tomography perfusion Not Applicable Detailed Description: Cardiac arrest is common and is associated with poor survival despite intensive medical care. These patients are subjected to cooling therapy to improve neurological outcomes. After cooling these patients are allowed to spontaneously return to normal body temperature. From here on, the outcome of these patients is mainly dependent on a wait and watch approach as the clinical examination of patients in a coma is very (...) Special Imaging Technique to Aid in the Diagnosis of Patients in Coma After Cardiac Arrest Special Imaging Technique to Aid in the Diagnosis of Patients in Coma After Cardiac Arrest - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove one or more

2014 Clinical Trials

67. Study for the Improvement of Long-Term Outcome Prediction in Patients in Coma After Cardiac Arrest

Study for the Improvement of Long-Term Outcome Prediction in Patients in Coma After Cardiac Arrest Study for the Improvement of Long-Term Outcome Prediction in Patients in Coma After Cardiac Arrest - Full Text View - ClinicalTrials.gov Hide glossary Glossary Study record managers: refer to the if submitting registration or results information. Search for terms x × Study Record Detail Saved Studies Save this study Warning You have reached the maximum number of saved studies (100). Please remove (...) one or more studies before adding more. Study for the Improvement of Long-Term Outcome Prediction in Patients in Coma After Cardiac Arrest (HOPE) The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our for details. ClinicalTrials.gov Identifier: NCT02231060 Recruitment Status : Completed First Posted : September 3, 2014 Last Update Posted : December 12

2014 Clinical Trials

68. Clinical Reasoning: A 42-year-old man with severe headache, fever, and acute coma. Full Text available with Trip Pro

Shan S Mao Chen-Hui CH Cui Li-Ying LY Xing Bing B Zhu Yi-Cheng YC eng Case Reports Journal Article Research Support, Non-U.S. Gov't United States Neurology 0401060 0028-3878 Apraxia, oculomotor, Cogan type AIM IM Adenoma diagnosis surgery Adult Apraxias congenital Cogan Syndrome diagnosis etiology Coma etiology Diagnosis, Differential Diffusion Magnetic Resonance Imaging Fever etiology Glasgow Coma Scale Headache etiology Humans Male Neurologic Examination Pituitary Apoplexy complications diagnosis (...) Clinical Reasoning: A 42-year-old man with severe headache, fever, and acute coma. 24419984 2014 03 07 2015 11 19 1526-632X 82 2 2014 Jan 14 Neurology Neurology Clinical Reasoning: a 42-year-old man with severe headache, fever, and acute coma. e9-13 10.1212/WNL.0000000000000014 Han Fei F From the Departments of Neurology (F.H., B.P, S.G., C.-H.M., L.-Y.C., Y.-C.Z.) and Neurosurgery (B.X.), Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China. Peng Bin B Gao

2014 Neurology

69. Moderate and severe traumatic brain injury: effect of blood alcohol concentration on Glasgow Coma Scale score and relation to computed tomography findings. Full Text available with Trip Pro

Moderate and severe traumatic brain injury: effect of blood alcohol concentration on Glasgow Coma Scale score and relation to computed tomography findings. The influence of alcohol is assumed to reduce consciousness in patients with traumatic brain injury (TBI), but research findings are divergent. The aim of this investigation was to study the effects of different levels of blood alcohol concentration (BAC) on the Glasgow Coma Scale (GCS) scores in patients with moderate and severe TBI (...) and to relate the findings to brain injury severity based on the admission CT scan.In this cohort study, 265 patients (age range 16-70 years) who were admitted to St. Olavs University Hospital with moderate and severe TBI during a 7-year period were prospectively registered. Of these, 217 patients (82%) had measured BAC. Effects of 4 BAC groups on GCS score were examined with ordinal logistic regression analyses, and the GCS scores were inverted to give an OR > 1. The Rotterdam CT score based on admission

2014 Journal of Neurosurgery

70. Contemporary approach to neurologic prognostication of coma after cardiac arrest. (Abstract)

Contemporary approach to neurologic prognostication of coma after cardiac arrest. Coma after cardiac arrest (CA) is an important cause of admission to the ICU. Prognosis of post-CA coma has significantly improved over the past decade, particularly because of aggressive postresuscitation care and the use of therapeutic targeted temperature management (TTM). TTM and sedatives used to maintain controlled cooling might delay neurologic reflexes and reduce the accuracy of clinical examination (...) . In the early ICU phase, patients' good recovery may often be indistinguishable (based on neurologic examination alone) from patients who eventually will have a poor prognosis. Prognostication of post-CA coma, therefore, has evolved toward a multimodal approach that combines neurologic examination with EEG and evoked potentials. Blood biomarkers (eg, neuron-specific enolase [NSE] and soluble 100-β protein) are useful complements for coma prognostication; however, results vary among commercial laboratory

2014 Chest

71. History and Mental Status Examination (Diagnosis)

History and Mental Status Examination (Diagnosis) History and Mental Status Examination: Overview, Patient History, Mental Status Examination Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjkzNDAyLW92ZXJ2aWV3 (...) processing > History and Mental Status Examination Updated: Mar 30, 2016 Author: Guy E Brannon, MD; Chief Editor: David Bienenfeld, MD Share Email Print Feedback Close Sections Sections History and Mental Status Examination Overview Overview The history and Mental Status Examination (MSE) are the most important diagnostic tools a psychiatrist has to obtain information to make an accurate diagnosis. Although these important tools have been standardized in their own right, they remain primarily subjective

2014 eMedicine.com

72. Neurological History and Physical Examination (Diagnosis)

Neurological History and Physical Examination (Diagnosis) Neurological History and Physical Examination: Neurological History, Neurologic Examination, Examination of the Higher Functions Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE0Nzk5My1vdmVydmlldw== processing > Neurological History and Physical Examination Updated: Dec 05, 2017 Author: Kalarickal J Oommen, MD, FAAN; Chief Editor: Stephen A Berman, MD, PhD, MBA Share Email Print Feedback Close Sections Sections Neurological History and Physical Examination Neurological History Taking the patient's history is traditionally the first step in virtually every clinical encounter. A thorough neurologic history allows the clinician to define the patient's problem and, along with the result

2014 eMedicine.com

73. History and Mental Status Examination (Treatment)

History and Mental Status Examination (Treatment) History and Mental Status Examination: Overview, Patient History, Mental Status Examination Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjkzNDAyLW92ZXJ2aWV3 (...) processing > History and Mental Status Examination Updated: Mar 30, 2016 Author: Guy E Brannon, MD; Chief Editor: David Bienenfeld, MD Share Email Print Feedback Close Sections Sections History and Mental Status Examination Overview Overview The history and Mental Status Examination (MSE) are the most important diagnostic tools a psychiatrist has to obtain information to make an accurate diagnosis. Although these important tools have been standardized in their own right, they remain primarily subjective

2014 eMedicine.com

74. Neurological History and Physical Examination (Treatment)

Neurological History and Physical Examination (Treatment) Neurological History and Physical Examination: Neurological History, Neurologic Examination, Examination of the Higher Functions Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE0Nzk5My1vdmVydmlldw== processing > Neurological History and Physical Examination Updated: Dec 05, 2017 Author: Kalarickal J Oommen, MD, FAAN; Chief Editor: Stephen A Berman, MD, PhD, MBA Share Email Print Feedback Close Sections Sections Neurological History and Physical Examination Neurological History Taking the patient's history is traditionally the first step in virtually every clinical encounter. A thorough neurologic history allows the clinician to define the patient's problem and, along with the result

2014 eMedicine.com

75. Neurological History and Physical Examination (Overview)

Neurological History and Physical Examination (Overview) Neurological History and Physical Examination: Neurological History, Neurologic Examination, Examination of the Higher Functions Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE0Nzk5My1vdmVydmlldw== processing > Neurological History and Physical Examination Updated: Dec 05, 2017 Author: Kalarickal J Oommen, MD, FAAN; Chief Editor: Stephen A Berman, MD, PhD, MBA Share Email Print Feedback Close Sections Sections Neurological History and Physical Examination Neurological History Taking the patient's history is traditionally the first step in virtually every clinical encounter. A thorough neurologic history allows the clinician to define the patient's problem and, along with the result

2014 eMedicine.com

76. History and Mental Status Examination (Overview)

History and Mental Status Examination (Overview) History and Mental Status Examination: Overview, Patient History, Mental Status Examination Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjkzNDAyLW92ZXJ2aWV3 (...) processing > History and Mental Status Examination Updated: Mar 30, 2016 Author: Guy E Brannon, MD; Chief Editor: David Bienenfeld, MD Share Email Print Feedback Close Sections Sections History and Mental Status Examination Overview Overview The history and Mental Status Examination (MSE) are the most important diagnostic tools a psychiatrist has to obtain information to make an accurate diagnosis. Although these important tools have been standardized in their own right, they remain primarily subjective

2014 eMedicine.com

77. History and Mental Status Examination (Follow-up)

History and Mental Status Examination (Follow-up) History and Mental Status Examination: Overview, Patient History, Mental Status Examination Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMjkzNDAyLW92ZXJ2aWV3 (...) processing > History and Mental Status Examination Updated: Mar 30, 2016 Author: Guy E Brannon, MD; Chief Editor: David Bienenfeld, MD Share Email Print Feedback Close Sections Sections History and Mental Status Examination Overview Overview The history and Mental Status Examination (MSE) are the most important diagnostic tools a psychiatrist has to obtain information to make an accurate diagnosis. Although these important tools have been standardized in their own right, they remain primarily subjective

2014 eMedicine.com

78. Neurological History and Physical Examination (Follow-up)

Neurological History and Physical Examination (Follow-up) Neurological History and Physical Examination: Neurological History, Neurologic Examination, Examination of the Higher Functions Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTE0Nzk5My1vdmVydmlldw== processing > Neurological History and Physical Examination Updated: Dec 05, 2017 Author: Kalarickal J Oommen, MD, FAAN; Chief Editor: Stephen A Berman, MD, PhD, MBA Share Email Print Feedback Close Sections Sections Neurological History and Physical Examination Neurological History Taking the patient's history is traditionally the first step in virtually every clinical encounter. A thorough neurologic history allows the clinician to define the patient's problem and, along with the result

2014 eMedicine.com

79. Myxedema Coma or Crisis (Diagnosis)

and monitoring of thyroid tests on a regular basis. Patients with a history of thyroiditis or who have undergone thyroid irradiation or thyroid surgery should be counseled that hypothyroidism might occur in the future. They should be educated about the symptoms of hypothyroidism and should understand the importance of seeking timely medical advice for examination and testing. Previous References Kwaku MP, Burman KD. Myxedema coma. J Intensive Care Med . 2007 Jul-Aug. 22(4):224-31. . Klubo-Gwiezdzinska J (...) Myxedema Coma or Crisis (Diagnosis) Myxedema Coma or Crisis: Practice Essentials, Pathophysiology, Epidemiology Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvMTIzNTc3LW92ZXJ2aWV3 processing > Myxedema Coma

2014 eMedicine.com

80. Hyperosmolar Coma (Treatment)

Hyperosmolar Coma (Treatment) Hyperosmolar Hyperglycemic State Treatment & Management: Approach Considerations, Standard Care for Dehydration and Altered Mental Status, Insulin Therapy for Correction of Hyperglycemia Edition: No Results No Results Please confirm that you would like to log out of Medscape. If you log out, you will be required to enter your username and password the next time you visit. https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache (...) management, IV access, crystalloid fluid replacement, and administration of any medications routinely given to coma patients. Airway management Protection of the airway is mandatory in patients presenting with mental status changes, obtundation, or unconsciousness. Patients may present with respiratory failure and circulatory collapse and must be ventilated mechanically. If patients are presenting with metabolic acidosis, take care to hyperventilate them when mechanical ventilation is instituted

2014 eMedicine.com

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