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Coma Exam

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81. Myxedema Coma or Crisis (Overview)

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 (Overview) 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

82. Hyperosmolar Coma (Follow-up)

Hyperosmolar Coma (Follow-up) 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

83. Hypothyroidism and Myxedema Coma (Treatment)

Hypothyroidism and Myxedema Coma (Treatment) Hypothyroidism and Myxedema Coma Treatment & Management: Prehospital Care, Emergency Department Care, Consultations 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 (...) =aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzY4MDUzLXRyZWF0bWVudA== processing > Hypothyroidism and Myxedema Coma Treatment & Management Updated: Feb 26, 2018 Author: Erik D Schraga, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP Share Email Print Feedback Close Sections Sections Hypothyroidism and Myxedema Coma Treatment Prehospital Care Stabilize acute life-threatening conditions in patients with hypothyroidism, and initiate supportive therapy. Next: Emergency Department Care Patients with myxedema coma may present in extremis; implement initial

2014 eMedicine Emergency Medicine

84. Hypothyroidism and Myxedema Coma (Follow-up)

Hypothyroidism and Myxedema Coma (Follow-up) Hypothyroidism and Myxedema Coma Follow-up: Further Inpatient Care, Complications, Prognosis 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzY4MDUzLWZvbGxvd3Vw (...) processing > Hypothyroidism and Myxedema Coma Follow-up Updated: Feb 26, 2018 Author: Erik D Schraga, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP Share Email Print Feedback Close Sections Sections Hypothyroidism and Myxedema Coma Follow-up Further Inpatient Care Further inpatient care is as follows: Admit patients with myxedema coma to ICU. Provide supportive ventilatory and hemodynamic management. Treat precipitating events (eg, infection). Continue rewarming as required. Confirm diagnosis

2014 eMedicine Emergency Medicine

85. Hypothyroidism and Myxedema Coma (Diagnosis)

Hypothyroidism and Myxedema Coma (Diagnosis) Hypothyroidism and Myxedema Coma: Background, 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzY4MDUzLW92ZXJ2aWV3 processing (...) > Hypothyroidism and Myxedema Coma Updated: Feb 26, 2018 Author: Erik D Schraga, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP Share Email Print Feedback Close Sections Sections Hypothyroidism and Myxedema Coma Overview Background is a clinical syndrome in which the deficiency or absence of thyroid hormone slows bodily metabolic processes. Symptoms can manifest in all organ systems and range in severity based on the degree of hormone deficiency. The disease typically progresses over months to years but can

2014 eMedicine Emergency Medicine

86. Hypothyroidism and Myxedema Coma (Overview)

Hypothyroidism and Myxedema Coma (Overview) Hypothyroidism and Myxedema Coma: Background, 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=aHR0cHM6Ly9lbWVkaWNpbmUubWVkc2NhcGUuY29tL2FydGljbGUvNzY4MDUzLW92ZXJ2aWV3 processing (...) > Hypothyroidism and Myxedema Coma Updated: Feb 26, 2018 Author: Erik D Schraga, MD; Chief Editor: Romesh Khardori, MD, PhD, FACP Share Email Print Feedback Close Sections Sections Hypothyroidism and Myxedema Coma Overview Background is a clinical syndrome in which the deficiency or absence of thyroid hormone slows bodily metabolic processes. Symptoms can manifest in all organ systems and range in severity based on the degree of hormone deficiency. The disease typically progresses over months to years but can

2014 eMedicine Emergency Medicine

87. Clinical examination for prognostication in comatose cardiac arrest patients. Full Text available with Trip Pro

Clinical examination for prognostication in comatose cardiac arrest patients. To build new algorithms for prognostication of comatose cardiac arrest patients using clinical examination, and investigate whether therapeutic hypothermia influences the value of the clinical examination.From 2000 to 2007, 500 consecutive patients in non-traumatic coma were prospectively enrolled, 200 of whom were post-cardiac arrest. Outcome was determined by modified Rankin Scale (mRS) score at 6 months, with mRS≤3 (...) indicating good outcome. The clinical examination was performed on days 0, 1, 3 and 7 post-arrest, and clinical variables analyzed for importance in prognostication of outcome. A classification and regression tree analysis (CART) was used to develop a predictive algorithm.Good outcome was achieved in 9.9% of patients. In CART analysis, motor response was often chosen as a root node, and spontaneous eye movements, pupillary reflexes, eye opening and corneal reflexes were often chosen as splitting nodes

2013 Resuscitation

88. Surveillance neuroimaging and neurologic examinations affect care for intracerebral hemorrhage. Full Text available with Trip Pro

neuroimaging at 6, 24, and 48 hours, and hourly neurologic examinations using the Glasgow Coma Scale and NIH Stroke Scale. We evaluated all cases of craniotomy and ventriculostomy to determine whether the procedure was part of the initial management plan or occurred subsequently. For those that occurred subsequently, we determined whether worsening on neurologic examination or worsened neuroimaging findings initiated the process leading to intervention.There were 88 surgical interventions in 84 (35 (...) Surveillance neuroimaging and neurologic examinations affect care for intracerebral hemorrhage. We tested the hypothesis that surveillance neuroimaging and neurologic examinations identified changes requiring emergent surgical interventions in patients with intracerebral hemorrhage (ICH).Patients with primary ICH were enrolled into a prospective registry between December 2006 and July 2012. Patients were managed in a neuroscience intensive care unit with a protocol that included serial

2013 Neurology

89. Glasgow coma scale for field triage of trauma: a systematic review

Glasgow coma scale for field triage of trauma: a systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing and effect measures (...) required for analysis should be specified. For further guidance please refer to the and to pre-clinical meta-analysis. Example: The following study characteristics will be examined as potential source of heterogeneity: species (stratified per species); sex (stratified per sex); duration of index ischemia (linear); stem cell dose (linear); blinding of outcome assessment reported (stratified yes vs no). For stratified analyses, a minimum number of 8 studies per subgroup is required. ">Subgroup analyses

2016 PROSPERO

90. Data quality of Glasgow Coma Scale and systolic blood pressure in physician staffed emergency medical services: systematic review

Data quality of Glasgow Coma Scale and systolic blood pressure in physician staffed emergency medical services: systematic review Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne (...) , a threshold describing the number of studies per subgroup required for analysis should be specified. For further guidance please refer to the and to pre-clinical meta-analysis. Example: The following study characteristics will be examined as potential source of heterogeneity: species (stratified per species); sex (stratified per sex); duration of index ischemia (linear); stem cell dose (linear); blinding of outcome assessment reported (stratified yes vs no). For stratified analyses, a minimum number of 8

2016 PROSPERO

91. Prognosis in prolonged coma patients with diffuse axonal injury assessed by somatosensory evoked potentia Full Text available with Trip Pro

Prognosis in prolonged coma patients with diffuse axonal injury assessed by somatosensory evoked potentia A total of 43 prolonged coma patients with diffuse axonal injury received the somatosensory evoked potential examination one month after injury in the First Affiliated Hospital, School of Medicine, Zhejiang University in China. Somatosensory evoked potentials were graded as normal, abnormal or absent (grades I-III) according to N20 amplitude and central conduction time. The outcome (...) in patients with grade III somatosensory evoked potential was in each case unfavorable. The prognostic accuracy of grade III somatosensory evoked potential for unfavorable and non-awakening outcome was 100% and 80%, respectively. The prognostic accuracy of grade I somatosensory evoked potential for favorable and wakening outcome was 86% and 100%, respectively. These results suggest that somatosensory evoked potential grade is closely correlated with coma severity and degree of recovery. Somatosensory

2013 Neural Regeneration Research

92. Fosphenytoin for seizure prevention in childhood coma in Africa: a randomized clinical trial. Full Text available with Trip Pro

Fosphenytoin for seizure prevention in childhood coma in Africa: a randomized clinical trial. We conducted a double-blind trial to determine whether a single intramuscular injection of fosphenytoin prevents seizures and neurologic sequelae in children with acute coma.We conducted this study at Kilifi District Hospital in coastal Kenya and Kondele Children's Hospital in western Kenya. We recruited children (age, 9 months to 13 years) with acute nontraumatic coma. We administered fosphenytoin (20 (...) phenytoin equivalents/kg) or placebo and examined the prevalence and frequency of clinical seizures and occurrence of neurocognitive sequelae.We recruited 173 children (median age, 2.6 [interquartile range, 1.7-3.7] years) into the study; 110 had cerebral malaria, 8 had bacterial meningitis, and 55 had encephalopathies of unknown etiology. Eighty-five children received fosphenytoin and 88 received placebo. Thirty-three (38%) children who received fosphenytoin had at least 1 seizure compared with 32 (36

2013 Journal of critical care Controlled trial quality: predicted high

93. Unexpected Relationship Between Tympanometry and Mortality in Children With Nontraumatic Coma. Full Text available with Trip Pro

Unexpected Relationship Between Tympanometry and Mortality in Children With Nontraumatic Coma. We sought to further examine the relationship between tympanometry and mortality after noting an unexpected association on assessment of baseline data of a study whose primary aim was to investigate the utility of noninvasive tympanic membrane displacement measurement for monitoring intracranial pressure in childhood coma.We recruited children who presented with acute nontraumatic coma to the high (...) died had a lower compliance (0.29 mL; IQR: 0.09-0.33 mL) compared with those who survived (0.48 mL; IQR: 0.29-0.70 mL) (P < .01).Abnormal tympanometry appears to be significantly associated with death in children with acute nontraumatic coma. This finding needs to be explored further through a prospective study that incorporates imaging and intensive physiologic monitoring.

2013 Pediatrics

94. Clinical examination for outcome prediction in nontraumatic coma. (Abstract)

Clinical examination for outcome prediction in nontraumatic coma. Determine the utility of the neurologic examination in comatose patients from nontraumatic causes in the modern era.Prospective observational study.Single academic medical center.Data from 500 patients in nontraumatic coma collected sequentially from 2000 to 2007 in the emergency department and neuroscience, medical, and cardiac intensive care units.None.Clinical data were collected on days 0, 1, 3, and 7. Outcome was assessed (...) ratio 2.35, 95% confidence interval 0.64-5.74 for modified Rankin Scale ≤3; odds ratio 2.1, 95% confidence interval 0.81-4.24 for modified Rankin Scale score ≤4). Age was not associated with outcome.The clinical neurologic examination remains central to determining prognosis in nontraumatic coma. Additional clinical and diagnostic variables may also aid in outcome prediction for specific disease states.

2011 Critical Care Medicine

95. The Nociception Coma Scale (-Revised): a systematic review of clinimetric properties

The Nociception Coma Scale (-Revised): a systematic review of clinimetric properties Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites. Email salutation (e.g. "Dr Smith" or "Joanne") for correspondence: Organisation web address: Timing (...) required for analysis should be specified. For further guidance please refer to the and to pre-clinical meta-analysis. Example: The following study characteristics will be examined as potential source of heterogeneity: species (stratified per species); sex (stratified per sex); duration of index ischemia (linear); stem cell dose (linear); blinding of outcome assessment reported (stratified yes vs no). For stratified analyses, a minimum number of 8 studies per subgroup is required. ">Subgroup analyses

2015 PROSPERO

96. Coma Algorithm

, Approach to Coma From Related Chapters II. Approach: Psychogenic Coma (EEG) Amytal interview III. Approach: Physiologic Coma with Nonfocal exam Evaluate laboratory data and correct abnormalities If labs Normal then evaluate as with Focal exam below IV. Approach: Physiologic Coma with Focal exam Step 1: Obtain , If Abnormal: : Supportive care , Tumor or tion Neurosurgical stat Decadron Mannitol No tion Supportive care Neurosurgical Step 2: Obtain , If Abnormal Antibiotics Neurosurgical Step 3: Unclear (...) Coma Algorithm Coma Algorithm Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Coma Algorithm Coma Algorithm Aka: Coma Algorithm

2015 FP Notebook

97. Coma

of dysfunction of awareness and arousal III. Pathophysiology Bilateral cortical disease Unilateral disease does not cause coma Metabolic and toxic derangements most common Focal Neurologic signs absent except in Suppression of Reticular Activating System (RAS) Supratentorial pressure Infratentorial pressure Cerebellar Posterior fossa tumor Intrinsic lesion tic pontine Hypertensive pontine Neurologic degenerative diseases tumor Torque on from sudden head blow IV. Exam See V. Differential Diagnosis See See (...) Psychogenic Coma (EEG) Amytal interview VI. Evaluation See Step 0: Review History, Exam, Labs Physiologic Coma with Nonfocal exam may suggest metabolic cause Step 1: Obtain and If Abnormal: : Supportive care , Tumor or tion Neurosurgical stat Decadron Mannitol No tion Supportive care Neurosurgical Step 2: Obtain and If Abnormal Antibiotics Neurosurgical Step 3: Unclear etiology (above testing normal) Etiologies infarct Drug Complex partial Evaluation (EEG) Management Supportive Care VII. Management See

2015 FP Notebook

98. Glasgow Coma Scale

Glasgow Coma Scale Glasgow Coma Scale Toggle navigation Brain Head & Neck Chest Endocrine Abdomen Musculoskeletal Skin Infectious Disease Hematology & Oncology Cohorts Diagnostics Emergency Findings Procedures Prevention & Management Pharmacy Resuscitation Trauma Emergency Procedures Ultrasound Cardiovascular Emergencies Lung Emergencies Infectious Disease Pediatrics Neurologic Emergencies Skin Exposure Miscellaneous Abuse Cancer Administration 4 Glasgow Coma Scale Glasgow Coma Scale Aka (...) : Glasgow Coma Scale , Pediatric Glasgow Coma Scale , GCS II. Indications III. Scoring Eye Opening Spontaneous: 4 To speech: 3 To pain: 2 No Response: 1 Best Verbal Response Oriented (Infant coos or babbles): 5 Confused (Infant irritable cries): 4 Inappropriate words (Infant Cries to pain): 3 Incomprehensible sounds (Infant Moans to pain): 2 No Response: 1 Best Motor Response Obeys (Infant moves spontaneous/purposefully): 6 Localizes (infant withdraws to touch): 5 Withdraws to pain: 4 Abnormal Flexion

2015 FP Notebook

99. Longitudinal Study of the Default-mode Network Connectivity in Brain Injured Patients Recovering From Coma

. The investigators hypothesized that DMN connectivity strength would be related to the level of consciousness of brain-damaged patients. The investigators will follow severely brain-injured patient in coma. Clinical examination using standardized behavioural scales: FOUR score (Full Outline of UnResponsivess), Coma Recovery Scale-Revised); and brain imaging assessesments using MRI (functional and anatomical connectivity, cortical thickness) will be performed at: 3 to 30 (visit 1), and 60 (visit 2) days after (...) Longitudinal Study of the Default-mode Network Connectivity in Brain Injured Patients Recovering From Coma Longitudinal Study of the Default-mode Network Connectivity in Brain Injured Patients Recovering From Coma - 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

2012 Clinical Trials

100. Preliminary framework for Familiar Auditory Sensory Training (FAST) provided during coma recovery. (Abstract)

Preliminary framework for Familiar Auditory Sensory Training (FAST) provided during coma recovery. Since there remains a need to examine the nature of the neural effect and therapeutic efficacy/effectiveness of sensory stimulation provided to persons in states of seriously impaired consciousness, a passive sensory stimulation intervention, referred to as the Familiar Auditory Sensory Training (FAST) protocol, was developed for examination in an ongoing, double-blind, randomized clinical trial (...) . The potential effect of the intervention is illustrated using functional brain imaging of nondisabled subjects. This illustration also demonstrates the relevance of the rationale for designing the FAST protocol. To put the intervention within the context of the scientific development process, the article culminates with a description of the study design for the ongoing RCT examining the efficacy of the FAST protocol.

2012 Journal of rehabilitation research and development Controlled trial quality: uncertain

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