Biniek R, Schindler E
Abteilung Neurologie, Rheinische Landesklinik, Bonn.
Nervenarzt. 1996 Dec;67(12):975-82. doi: 10.1007/s001150050079.
The unconscious patient presents an challenging emergency in the intensive care unit. Patient evaluation and treatment must occur simultaneously. After checking vital signs, deciding about cardiopulmonary resuscitation or intubation, an intravenous line must be established, blood samples collected and glucose and thiamine should be given. The physical and neurological examination should be performed in a efficient way and must consider the following eight points: best reaction to loud commands, best motor reaction to noxious stimuli, respiratory pattern, size and reactions of pupils, eye movements, corneal and blink reflex, meningismus, muscle tone and deep tendon reflexes. With this approach it is possible to formulate a working diagnosis, and the appropriate diagnostic steps can be performed.
昏迷患者在重症监护病房是一个具有挑战性的急症情况。患者评估和治疗必须同时进行。检查生命体征、决定是否进行心肺复苏或插管后，必须建立静脉通路、采集血样并给予葡萄糖和硫胺素。体格检查和神经检查应以高效的方式进行，并且必须考虑以下八点：对大声指令的最佳反应、对有害刺激的最佳运动反应、呼吸模式、瞳孔大小及反应、眼球运动、角膜反射和眨眼反射、颈项强直、肌张力和深腱反射。通过这种方法可以做出初步诊断，并可进行适当的诊断步骤。
