Management of the Child with a Decreased Conscious Level

Children present with a decreased level of consciousness for a host of different reasons. Some causes are obvious but others much more obscure. This evidence-based guideline has been developed to help junior doctors recognise clinically important problems, investigate and treat them.

This guideline can be applied to any child with a Glasgow coma score less than 15 or responding only to Voice, Pain or being Unresponsive on the AVPU score.

This guideline should not be applied to preterm infants on the neonatal unit, children for whom a known cause of their decreased conscious level exists (e.g. children with epilepsy, children with a ventriculo-peritoneal shunt, or children with a diagnosed metabolic condition), and children with a chronic abnormal conscious level.

Currently, the guideline can only be downloaded to print a hard copy. To do this click on the "algorithm" box below. In future, the guideline will be available in a format to download onto a hand-held computer.

To download a printable copy of the guideline please click here

This guideline has been developed using rigorous methodology and has been appraised and endorsed by the Royal College of Paediatrics and Child Health