Guidelines for the investigation and management of a reduced level of consciousness in children: implications for clinical biochemistry laboratories.
Ann Clin Biochem
; 44(Pt 6): 506-11, 2007 Nov.
Article
en En
| MEDLINE
| ID: mdl-17961303
ABSTRACT
Whenever a child presents to hospital with a reduced level of consciousness, admitting clinicians have to decide the underlying cause rapidly so that the correct emergency treatment can be initiated. Unfortunately, the clinical presentations of many of the possible diagnoses are very similar. The diagnosis often results from investigations within the clinical biochemistry laboratory. In the past, clinicians have had limited guidance on which tests to request when presented with a child with a reduced level of consciousness. Guidelines have recently been developed relating to all aspects of management of the child in a coma. Due to a lack of evidence in the literature regarding the most appropriate first line tests for children with a reduced level of consciousness, a formal consensus process ('Delphi consensus') was performed using a large multidisciplinary panel of experts. The recommendations reached by this process include the list of initial ('core') tests to request for all children with a reduced level of consciousness (excluding those immediately after suffering a convulsion and those involved in obvious trauma). Depending upon the results of these 'core' tests and the clinical condition of the child, further tests may be requested later. The key point is that all the samples have been taken at the time of presentation to provide the best chance of reaching a diagnosis and correctly treating the child. The article reviews the recommended core investigations and further tests and discusses how individual laboratories can help to implement the guidelines jointly with their Emergency and Paediatric Departments.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Guías como Asunto
/
Trastornos de la Conciencia
/
Pruebas de Química Clínica
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Guideline
Límite:
Child
/
Humans
Idioma:
En
Revista:
Ann Clin Biochem
Año:
2007
Tipo del documento:
Article
País de afiliación:
Reino Unido