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PAEDIATRIC ALTERED
CONSCIOUS LEVEL GUIDELINE |
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Scope Module 2
Which patients should
be included in module two of the guideline?
All children whose altered conscious level remains undiagnosed
following review of first line investigations.
Which patients should
be excluded from module two of the guideline?
Those children who, after review of the first line
investigations, have a known cause for their altered conscious level and are
being treated for that cause.
What is the starting
point for module two of the guideline?
When the initial first line investigations are available and
after review no clear cause for the altered conscious level is known.
Supportive measures may need to be or may have been initiated but second line
investigation results will be required before definitive management plans can
be made confidently.
What are the end
points for module two of the guideline?
There are many second line investigations available for this
group of patients from electroencephalograms to mitochondrial enzyme assays.
Some of these results will be available immediately and others will take weeks
to come back. Treatment options also vary from acute intracranial pressure
reducing measures to long term dietary management. The end points for the
second module of the guideline have been discussed and agreed to the general
principle of appropriate tests being sent and appropriate treatment plans in
place, but the underlying diagnosis may not have been established by the end of
the guideline (indeed “undiagnosed coma” may be the final clinical description
for some of these patients).