3.5.

3 Summary: Coma and convulsions

Recognise the signs:

Coma (AVPU = P or U)
Convulsions
Pupillary reaction

Emergency management:

A: Maintain an open airway

B: Provide O2 (high flow)

Monitor SpO2

C: Ensure IV/IO access and support circulation

Emergency investigations

D: Treat hypoglycaemia
Treat convulsions (diazepam)
Place in recovery position

E: Treat hypothermia/hyperthermia,
Maintain temperature

Treatment and surveillance according to cause:

Hypoglycaemia Febrile convulsions Meningitis/ Cerebral malaria

Encephalitis

Treat hypoglycaemia Search for signs of Check RDT

<60mg/dL meningitis
(or 3.3 mmol/L)
LP for CSF testing Anti-malarial
Repeat glucose
testing after 30 Antibiotics
minutes