…despite maximally tolerated therapy. It is a prodrug activated predominantly in the liver by very long chain acyl CoA synthetase 1. This activating enzyme is…

…effect varies tenfold between individuals, and the only way to find the right level is to give a small dose, wait until it has worked…

…laboratory abnormalities indicate end organ injury. Eclampsia is the occurrence of new onset seizures or coma in a pregnant woman with preeclampsia. HELLP syndrome—haemolysis…

…Aspiration Chronic obstructive pulmonary disease (COPD) Bronchospasm (asthma) Other : Coma Central hypoventilation syndromes Neuromuscular diseases Anemia The natural course of asphyxia Should ventilation be entirely…

…Neurological symptoms, confusion, convulsion, tachycardia, hypotension, coma. As above but with lower temperatures. Electrolyte replacement. Large infusions of fluids are typically needed. Table 1. Grading…

…L pH < 7.00 or bicarbonate < 10 mmol/L Stupor or coma may occur Mixed picture of DKA and HHS Overlap is common…

…fibreoptic intubation. A difficult airway is anticipated in a stable patient — awake fibreoptic intubation or anaesthetic back up is then the right course, not RSI…

…can cause: difficulty concentrating irritability or abnormal behaviour slurred speech visual disturbance confusion focal neurological signs drowsiness or unconsciousness seizures coma The symptom threshold varies…

…explanation: Seizures A deeply reduced level of consciousness Coma Marked drowsiness, for example a Glasgow Coma Scale below 8 Vomiting together with clear neurological impairment…

…Remove contaminated clothing and wash the skin after external exposure A low Glasgow Coma Scale is not on its own an absolute indication for intubation…

…muscle cramps, apathy, confusion, impaired reflexes. Severe <115 mmol/L Seizures, coma, respiratory arrest, brainstem herniation and death. Table 2. Grading of hyponatremia. Hypernatremia Hypernatremia…

…s outcome: Neurological injury Myocardial dysfunction Systemic response to reperfusion and ischemia Effects of the underlying cause of cardiac arrest Neurological injuries may cause coma…