title: Altered Level Of Consciousness: Evidence-Based Management In The Emergency Department.
abstract: A child who presents to the emergency department with an altered level of consciousness can be clinically unstable and can pose a great diagnostic challenge. The emergency clinician must quickly develop a wide differential of possible etiologies in order to administer potentially life-saving medications or interventions. The history, physical examination, and appropriate diagnostic tests can aid greatly in rapidly narrowing the differential diagnosis. Once initial stabilization, workup, and first-line interventions are completed, most patients who present with unresolved or unidentified altered level of consciousness should be admitted for further evaluation and close monitoring. This issue provides a review of the etiologies of altered level of consciousness as well as guidance for the management and disposition of patients with this condition.
authors.affiliation: Fellow, Division of Emergency and Transport Medicine, Children's Hospital Los Angeles, Los Angeles, CA.
authors.forename: Joo Lee
authors.initials: JL
authors.lastname: Song
authors.affiliation: Professor of Pediatrics, Keck School of Medicine of the University of Southern California; Associate Division Head, Division of Emergency Medicine, Children's Hospital Los Angeles, Los Angeles, CA.
authors.forename: Vincent J
authors.initials: VJ
authors.lastname: Wang
mesh_terms: D001145:Arrhythmias, Cardiac / Q000150:complications / Q000175:diagnosis; D001927:Brain Diseases / Q000150:complications / Q000175:diagnosis; D001930:Brain Injuries / Q000150:complications / Q000175:diagnosis; D002249:Carbon Monoxide Poisoning / Q000150:complications / Q000175:diagnosis; D002648:Child; D003244:Consciousness Disorders / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D019468:Disease Management; D004636:Emergency Service, Hospital; D004660:Encephalitis / Q000150:complications / Q000175:diagnosis; D004827:Epilepsy / Q000150:complications / Q000175:diagnosis; D055416:Evidence-Based Emergency Medicine; D005334:Fever / Q000150:complications / Q000175:diagnosis; D006801:Humans; D007003:Hypoglycemia / Q000150:complications / Q000175:diagnosis; D007035:Hypothermia / Q000150:complications / Q000175:diagnosis; D000860:Hypoxia / Q000150:complications / Q000175:diagnosis; D008581:Meningitis / Q000150:complications / Q000175:diagnosis; D000070316:Pediatric Emergency Medicine; D011041:Poisoning / Q000150:complications / Q000175:diagnosis; D012769:Shock / Q000150:complications / Q000175:diagnosis; D020521:Stroke / Q000150:complications / Q000175:diagnosis; D013575:Syncope / Q000150:complications / Q000175:diagnosis; D014883:Water-Electrolyte Imbalance / Q000150:complications / Q000175:diagnosis