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