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Management of Neurologic and Psychiatric Illness in the Patient with Heart Failure
Published in Andreas P. Kalogeropoulos, Hal A. Skopicki, Javed Butler, Heart Failure, 2023
Evangelos Pavlos Myserlis, Grigorios Kalaitzidis
In order to aid the diagnosis of delirium, a formal assessment of cognitive function should be conducted. The most widely used delirium screening tool is the Confusion Assessment Method.39 It is based on four key diagnostic features of delirium, namely (1) acute onset and fluctuating course, (2) inattention, (3) disorganized thinking, and (4) altered level of consciousness.40
Burns
Published in Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal, Plastic Surgery for Trauma, 2022
Dorian Hobday, Ted Welman, Maxim D. Horwitz, Gurjinderpal Singh Pahal
In patients with altered level of consciousness or who are irritable consider hypoxia, CO poisoning, shock, associated injury, substance abuse or pre-existing medical conditions as potential reversible causes.
Management of the Sick Child
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Assessment of ‘D – disability’ includes assessing a patient’s level of consciousness. An altered level of consciousness can be due to many reasons (medical and surgical). This is an acute life-threatening emergency and requires prompt recognition and emergency treatment.3 The child should be evaluated using a recognised consciousness scale such as AVPU. Other examples include Paediatric Glasgow Coma Scale (PGCS) (<15 indicates altered level of consciousness) and Blantyre Coma Scale (used in cerebral malaria, <4 indicates altered level of consciousness).
Two Useful Umbilical Biomarkers for Therapeutic Hypothermia Decision in Patients with Hypoxic İschemic Encephalopathy with Perinatal Asphyxia: Netrin-1 and Neuron Specific Enolase
Published in Fetal and Pediatric Pathology, 2022
Ufuk Cakir, Burak Ceran, Cuneyt Tayman
The severity assessment of the HIE was performed according to Sarnat and Sarnat score [14]. Moderate-to-severe (II-III) HIE, and decision for moderate whole-body cooling were considered according to the clinical and laboratory criteria: (i) at least one of these: the need for ventilation that continues up to 10 min after birth; 5 min Apgar score ≤ 5; pH < 7.0 or base excess (BE)≤ −16 mmol/L within first 1 h after birth, and (ii) altered level of consciousness, as well as at least one of the findings: abnormal reflexes, hypotonia or seizures. The moderate therapeutic hypothermia protocol was applied to all patients with HIE stage II/III in line with the recommendations of the “Total Body Hypothermia for Perinatal Asphyxia (TOBY)” study group [15]. Amplitude-integrated electroencephalography (aEEG) data were recorded by using an Olympic CFM 6000 (Natus, Seattle, WA) device, and severe abnormal traces were recorded.
Decreasing pressure injuries and acute care length of stay in patients with acute traumatic spinal cord injury
Published in The Journal of Spinal Cord Medicine, 2021
Gabrielle Gour-Provencal, Jean-Marc Mac-Thiong, Debbie E. Feldman, Jean Bégin, Andréane Richard-Denis
Previous work showed that longer acute care length of stay (LOS) and the occurrence of medical complications during acute care negatively influenced the course of IFR and long-term functional outcome, even when adjusted for important confounding variables such as the level and severity of the TSCI.7,11,12 One of the most common and preventable complications following TSCI is the occurrence of a pressure injury (PI), a serious complication that has the potential to interfere with functional, psychological and social well-being outcomes.6,13,14 Compared to other rehabilitation phases, the acute hospitalization represents the period with the highest PI risk.15,16 Indeed, the occurrence of altered level of consciousness, multiple concomitant traumatic injuries and severe neurological deficits represent some of the important factors leading to prolonged periods of immobility and decreased general health status, putting patients at higher risk of PI during acute care.17 Preventing PI during the acute care phase is of crucial importance, as its occurrence is associated with higher rates of medical complications, recurrence18–21 and may interfere with rehabilitation, limiting the long-term functional outcome.22–24
Stroke mimics: incidence, aetiology, clinical features and treatment
Published in Annals of Medicine, 2021
Brian H. Buck, Naveed Akhtar, Anas Alrohimi, Khurshid Khan, Ashfaq Shuaib
Focal seizures are common and may be seen in patients with a previous stroke [82]. Post-ictal Todd’s and muteness paralysis may be confused for acute stroke especially if the seizure was unwitnessed. Altered level of consciousness is common. Generalized seizures may also be an initial manifestation of an acute stroke. Recovery is rapid in most patients although rarely non-convulsive status epilepticus may present with prolonged aphasia or motor weakness (see Figure 4).