Coma: conditions to exclude as cause MIDAS:

Meningitis
Intoxication
Diabetes
Air (respiratory failure)
Subdural/ Subarachnoid hemorrhage
Resuscitation: basic steps ABCDE:
Airway
Breathing
Circulation
Drugs
Environment
Malignant hyperthermia treatment
"Some Hot Dude Better Give Iced Fluids Fast!"
(Hot dude = hypothermia):
Stop triggering agents
Hyperventilate/ Hundred percent oxygen
Dantrolene (2.5mg/kg)
Bicarbonate
Glucose and insulin
IV Fluids and cooling blanket
Fluid output monitoring/ Furosemide/ Fast heart [tachycardia]
Vfib/Vtach drugs used according to ACLS "Every Little Boy Must
Pray":
Epinephrine
Lidocaine
Bretylium
Magsulfate
Procainamide

Coma causes checklist AEIOU TIPS:

Acidosis/ Alcohol
Epilepsy
Infection
Overdosed
Uremia
Trauma to head
Insulin: too little or or too much
Pyschosis episode
Stroke occurred
Shock: types RN CHAMPS:
Respiratory
Neurogenic
Cardiogenic
Hemorrhagic
Anaphylactic
Metabolic
Psychogenic
Septic
Alternatively: "MR. C.H. SNAP", or "NH CRAMPS".
Shock: signs and symptoms TV SPARC CUBE:
Thirst
Vomiting
Sweating
Pulse weak
Anxious
Respirations shallow/rapid
Cool
Cyanotic

Unconscious
BP low
Eyes blank
Fall: potential causes CLADE SPADE:
Cardiovascular/ Cerebrovascular
Locomotor (skeletal, muscular, neurological)
Ageing (increased body sway, decreased reaction time)
Drugs (esp. antihypertensives, antipsychotics)
Environmental
Sensory deficits (eg. visual problems)
Psychological/ Psychiatric (depression)
Acute illness
Dementia
Epilepsy
Diabetic ketoacidosis management F*KING:
Fluids (crytalloids)
Urea (check it)
Creatinine (check it)/ Catheterize
K+ (potassium)
Insulin (5u/hour. Note: sliding scale no longer recommended in the UK)
Nasogastic tube (if patient comatose)
Glucose (once serum levels drop to 12)
Asthma: management of acute severe "O S#!T":
Oxygen (high dose: >60%)
Salbutamol (5mg via oxygen-driven nebuliser)
Hydrocortisone (or prednisolone)
Ipratropium bromide (if life threatening)
Theophylline (or preferably aminophylline-if life threatening)

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