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Non-traumatic coma in children
F J KirkhamNeurosciences
Unit, Institute of Child Health (University College London), 30 Guilford Street, London WC1N 1EH and Great Ormond Street Hospital For
Children NHS Trust, London WC1N 3JH, UK
Correspondence to: Dr F J Kirkham, Senior Lecturer in Paediatric Neurology, Neurosciences Unit, Institute of Child Health (UCL), The Wolfson Centre, Mecklenburgh Square, London WC1N 2AP, UK F.Kirkham@ich.ucl.ac.uk
| The first 150 words of the full text of this article appear below. |
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Introduction |
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Many acutely ill children are not fully conscious. Most make a full neurological recovery as the underlying cause is treated, but considerable skill is required to distinguish the group at high risk of further deterioration, potentially leading either to death or to severe handicap. This article is an attempt to guide the worried paediatrician in casualty or on the ward faced with a child in non-traumatic coma who may need intensive care. The most effective method of deciding the order of priorities in this emergency situation is to ask oneself a series of questions.
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Is the child unconscious and if so, how deeply? |
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This is the most important question of all and may well be the
most difficult to answer. The Glasgow Coma Scale was designed to assess
depth of coma after head injury in adults and has been used in
paediatric non-traumatic coma.1-3 Although alternatives such as the Seshia scale have less interobserver variability, probably
because there are
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