Critical Matters Acute Disorders of Consciousness
11 snips
Jul 13, 2023 Dr. Cherylee Chang, a neurointensivist and Professor of Neurology at Duke University, dives into the complexities of acute disorders of consciousness. She highlights the significance of a systematic approach to diagnosis and the importance of objective scoring systems like GCS and NIHSS. Dr. Chang discusses the nuances of neurological examinations and shares insights on imaging strategies, including the use of EEG in critical cases. Her advice on challenging traditional practices reinforces a commitment to evidence-based medicine and improving patient care.
AI Snips
Chapters
Books
Transcript
Episode notes
Delirium And Coma Are A Continuum
- Acute encephalopathy underlies delirium and coma as a continuum that develops over hours to days.
- Recognize delirium and coma as manifestations of the same acute pathobiologic process to guide evaluation.
Use A Systematic Bedside Framework
- Use a structured bedside approach: history, focused neurologic exam, then targeted imaging and labs.
- Let focal findings guide imaging and lab choices instead of shotgun testing.
Do A Precise Neurologic Exam
- Perform a rapid but complete neurologic exam including cranial nerves and pupils; document specifics rather than "non-focal."
- A concise exam often takes only one to two minutes but crucially guides the workup.
