Approach to the Child with Reduced Level of Consciousness

Rapid response teams are frequently called upon to assess and assist with the management of a child with depressed level of consciousness. Unlike in a cardiorespiratory decompensation scenario where there are very clearly outlined algorithmic approaches, assessment of an unresponsive child is more complex and requires going down a long list of differential diagnoses that influence decisions regarding further evaluation and management. This chapter provides a clear and simplified approach to this clinical scenario by focusing on key symptoms and signs, their implications, and immediate lifesaving interventions. Using the approach outlined in this chapter, clinicians could provide effective life- and brain-saving interventions based on a strong foundation in clinical examination assisted by investigations wherever necessary. With millions of neurons at risk of dying every minute, a systematic approach during a neurological emergency such as this could be the difference between debilitating neurological disability and high-quality long-term survival.