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Coma, Pediatric

Jennifer Huffman, MD and Preetha Krishnan, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Coma is defined as a state in which the patient appears to be asleep, shows no awareness of his or her surroundings, and cannot be aroused. Coma frequently is only a transient state,...

DIAGNOSIS

HISTORY

  • Question: Evidence or history of head trauma, drowning, or other trauma?

  • Significance: Are there concerns for nonaccidental trauma?

  • Question: What medications are in the home? Has the p...

TREATMENT

SURGERY/OTHER PROCEDURES

Neurosurgical intervention may be required in cases of head trauma, hemorrhage, mass lesion, or hydrocephalus. Neurology consultation is usually indicated. 

ADMISSION, INPATIENT, AND NURSING CONSIDERATIONS

ONGOING CARE

PROGNOSIS

  • Prognosis depends on underlying etiology and patient’s clinical course. It is not advised to prognosticate too early.

  • Serial exams combined with diagnostic tests (electrophysiolog...

ADDITIONAL READING

  • Abend NS, Licht DJ. Predicting outcome in children with hypoxic ischemic encephalopathy. Pediatr Crit Care Med.  2008;9(1):32–39. [View Abstract on OvidInsights]

  • Kochanek PM, Ca...

CODES

ICD9

  • 780.01 Coma

  • 781.99 Other symptoms involving nervous and musculoskeletal systems

  • 780.03 Persistent vegetative state

  • 779.2 Cerebral depression, coma, and other abnormal cerebral signs in fetus or...

FAQ

  • Q: When a bacterial infection is suspected as a potential etiology of coma, should antibiotic therapy be delayed until CSF has been obtained for testing?

  • A: Antibiotics should not be delayed if pat...

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