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GCS Drop

Last Updated on July 5, 2022

“Doktor, patient ini GCS drop!!”

Differential Diagnosis

• Hypoglycaemia
• Electrolyte imbalance (e.g. hyponatraemia)
• Acute stroke – ischaemic / haemorrhagic
• Acute myocardial infarction
Pulmonary embolism
• Shock, secondary to primary cause

History Taking

Some history to ask if you are first time seeing this patient
• When was patient last well condition?
• Patient currently admitted for what?
• Any fall?
• Any weakness?

Investigation

Bedside

Dxt
• ECG

Laboratory

• FBC, RP, Ca, Mg, PO4
Troponin T
• ABG

Imaging

• CT brain (if indicated)

Management

• Attend patient stat
• Check vital signs and capillary blood glucose
• Assess patient based on ABCDE+ Inform MO
• Transfer patient to acute cubicle

Consideration:
• If patient has no pulse, follow the ALS protocol
• May require rapid sequence intubation to secure airway
• May require Anaesth referral

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Identify underlying cause and treat accordingly

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