Paediatric Emergencies: Altered Level of Consciousness

The purpose of this course is to equip healthcare providers with the essential knowledge and practical skills that enable them to not only recognise an alteration in consciousness, but also to adequately assess, manage causes, escalate care appropriately and safely, and, in doing so, may prevent irreversible harm and reduce child mortality.

Course outline

This course covers the following content:

Paediatric Emergency Series: An Approach to a Child with Altered Level of Consciousness
Module 1: What is consciousness? Definition Spectrum of impaired consciousness Potential outcomes of coma Module 2: Conditions mistaken for coma: Deep sleep Complete paralysis Akinetic mutism Psychiatric unresponsiveness/catatonia Module 3: Recognition of altered consciousness: Clinical assessment tools Additional clinical indicators Module 4: Stabilisation and management at primary care: Acute, life-threatening emergency Rapid structured approach: ABCDE Reversible causes Module 5: General supportive measures Positioning and aspiration prevention Fluid management and temperature control Skin care Monitoring and interventions Module 6: Escalation of care and safe referral Referral and escalation Tertiary emergency units Interfacility communication Types of transfers Communication during transfer handover Module 7: Hospital management and investigation Primary survey on arrival Neuroprotection at the bedside Bedside testing Basic laboratory investigations Infection workup Imaging Specialised or directed tests Module 8: Important causes & clinical pictures Trauma Metabolic/endocrine Infections Oxygen deprivation: Hypoxic ischaemic encephalopathy Hypertensive crisis in children Toxins/drugs Opioids Sedative-hypnotics Cholinergic toxidrome Sympathomimetic toxidrome Anticholinergic toxidrome Hallucinogenic toxidrome Serotonin syndrome

Paediatric Emergency Series: An Approach to a Child with Altered Level of Consciousness

Module 1: What is consciousness?
- Definition
- Spectrum of impaired consciousness
- Potential outcomes of coma
Module 2: Conditions mistaken for coma:
- Deep sleep
- Complete paralysis
- Akinetic mutism
- Psychiatric unresponsiveness/catatonia
Module 3: Recognition of altered consciousness:
- Clinical assessment tools
- Additional clinical indicators
Module 4: Stabilisation and management at primary care:
- Acute, life-threatening emergency
- Rapid structured approach: ABCDE
- Reversible causes
Module 5: General supportive measures
- Positioning and aspiration prevention
- Fluid management and temperature control
- Skin care
- Monitoring and interventions
Module 6: Escalation of care and safe referral
- Referral and escalation
- Tertiary emergency units
- Interfacility communication
- Types of transfers
- Communication during transfer handover
Module 7: Hospital management and investigation
- Primary survey on arrival
- Neuroprotection at the bedside
- Bedside testing
- Basic laboratory investigations
- Infection workup
- Imaging
- Specialised or directed tests
Module 8: Important causes & clinical pictures
- Trauma
- Metabolic/endocrine
- Infections
- Oxygen deprivation: Hypoxic ischaemic encephalopathy
- Hypertensive crisis in children
- Toxins/drugs
- Opioids
- Sedative-hypnotics
- Cholinergic toxidrome
- Sympathomimetic toxidrome
- Anticholinergic toxidrome
- Hallucinogenic toxidrome
- Serotonin syndrome

Western Cape Government Department of Health and Wellness
People Development Centre

Acknowledgements:

University of Cape Town’s Knowledge & Instructional Development (KIDS) Training Hub
Knowledge Translation Unit

About the course

If you meet the eligibility criteria, apply to start:

Course outline