Disorders of consciousness

The disorders of consciousness are, in Hungarian literature, usually separated into hypnoid and non-hypnoid types. The hypnoid ones are the most important. They are:

• Somnolence – patient is sleepy but can be aroused by voice
• Sopor – patient is unconscious and can only be aroused by pain
• Coma – patient is unconscious and cannot be aroused

Evaluation

Consciousness is usually evaluated by the Glasgow coma scale, which scores the consciousness from 3 – 15, based on the motor response, verbal response, and eye response to commands or stimuli. A score of 8 or less is an indication for intubation, as the person is no longer able to protect their airway.

It can also be evaluated by the much simpler AVPU scale, where the patient is marked as either:

• A – alert
• V – responds to verbal stimulus
• P – responds to pain
• U – unresponsive

Etiology

The possible causes of disordered consciousness are endless but can be remembered by the mnemonic ATOMIC:

• Alcohol intoxication,
• Trauma
• Overdose (of drugs other than alcohol),
• Metabolic
• Infection
• CO2 narcosis