{"id":166,"date":"2014-03-17T02:49:33","date_gmt":"2014-03-17T02:49:33","guid":{"rendered":"https:\/\/www.pupdoc.ca\/?page_id=166"},"modified":"2025-10-08T01:23:38","modified_gmt":"2025-10-08T01:23:38","slug":"altered-loc","status":"publish","type":"page","link":"https:\/\/www.pupdoc.ca\/en\/altered-loc\/","title":{"rendered":"Altered Level of Consciousness"},"content":{"rendered":"<p>[et_pb_section fb_built=&#8221;1&#8243; inner_shadow=&#8221;on&#8221; fullwidth=&#8221;on&#8221; _builder_version=&#8221;4.16&#8243; background_color=&#8221;#961622&#8243; global_colors_info=&#8221;{}&#8221;][et_pb_fullwidth_header title=&#8221;Altered Level of Consciousness&#8221; text_orientation=&#8221;center&#8221; _builder_version=&#8221;4.16&#8243; background_color=&#8221;rgba(255, 255, 255, 0)&#8221; button_one_letter_spacing_hover=&#8221;0&#8243; button_two_letter_spacing_hover=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; button_one_text_size__hover_enabled=&#8221;off&#8221; button_one_text_size__hover=&#8221;null&#8221; button_two_text_size__hover_enabled=&#8221;off&#8221; button_two_text_size__hover=&#8221;null&#8221; button_one_text_color__hover_enabled=&#8221;off&#8221; button_one_text_color__hover=&#8221;null&#8221; button_two_text_color__hover_enabled=&#8221;off&#8221; button_two_text_color__hover=&#8221;null&#8221; button_one_border_width__hover_enabled=&#8221;off&#8221; button_one_border_width__hover=&#8221;null&#8221; button_two_border_width__hover_enabled=&#8221;off&#8221; button_two_border_width__hover=&#8221;null&#8221; button_one_border_color__hover_enabled=&#8221;off&#8221; button_one_border_color__hover=&#8221;null&#8221; button_two_border_color__hover_enabled=&#8221;off&#8221; button_two_border_color__hover=&#8221;null&#8221; button_one_border_radius__hover_enabled=&#8221;off&#8221; button_one_border_radius__hover=&#8221;null&#8221; button_two_border_radius__hover_enabled=&#8221;off&#8221; button_two_border_radius__hover=&#8221;null&#8221; button_one_letter_spacing__hover_enabled=&#8221;on&#8221; button_one_letter_spacing__hover=&#8221;0&#8243; button_two_letter_spacing__hover_enabled=&#8221;on&#8221; button_two_letter_spacing__hover=&#8221;0&#8243; button_one_bg_color__hover_enabled=&#8221;off&#8221; button_one_bg_color__hover=&#8221;null&#8221; button_two_bg_color__hover_enabled=&#8221;off&#8221; button_two_bg_color__hover=&#8221;null&#8221;][\/et_pb_fullwidth_header][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; inner_shadow=&#8221;on&#8221; _builder_version=&#8221;4.16&#8243; background_color=&#8221;#ffffff&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row _builder_version=&#8221;4.16&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;4_4&#8243; _builder_version=&#8221;4.16&#8243; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_tabs module_class=&#8221;key-conditions&#8221; _builder_version=&#8221;4.27.4&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; hover_enabled=&#8221;0&#8243; z_index_tablet=&#8221;500&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;][et_pb_tab title=&#8221;Key Conditions&#8221; _builder_version=&#8221;4.25.1&#8243; body_font=&#8221;||||&#8221; tab_font=&#8221;||||&#8221; global_colors_info=&#8221;{}&#8221;]Head Injury<br \/>\nHypoglycemia<br \/>\nMetabolic disease[\/et_pb_tab][et_pb_tab title=&#8221;Foundational Knowledge&#8221; _builder_version=&#8221;4.27.4&#8243; body_font=&#8221;||||&#8221; tab_font=&#8221;||||&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<ul>\n<li>Describe the anatomy and physiology of the central and peripheral nervous systems<\/li>\n<li>Describe in basic terms the pathophysiology of brain injury<\/li>\n<li>Describe how the brain maintains consciousness, how unconsciousness occurs and the differences between unconsciousness and sleep<\/li>\n<li>Name and classify the most common CNS pathogens, based on organism type and area of brain commonly affected<\/li>\n<li>Discuss the indications for the use of the different modalities available to assess neurologic structure and function<\/li>\n<li>Describe metabolic and electrolyte abnormalities that cause altered level of consciousness<\/li>\n<\/ul>\n<p>[\/et_pb_tab][et_pb_tab title=&#8221;Resources&#8221; _builder_version=&#8221;4.27.4&#8243; body_font=&#8221;||||&#8221; tab_font=&#8221;||||&#8221; hover_enabled=&#8221;0&#8243; global_colors_info=&#8221;{}&#8221; sticky_enabled=&#8221;0&#8243;]<div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Overview &amp; Foundational Knowledge<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><table>\n<tbody>\n<tr>\n<td><strong>Learn Pediatrics:  Approach to the Comatose Child<\/strong><\/p>\n<p><a href=\"http:\/\/learn.pediatrics.ubc.ca\/body-systems\/nervous-syste\/approach-to-the-comatose-child\/\" target=\"_blank\" rel=\"noopener noreferrer\">http:\/\/learn.pediatrics.ubc.ca\/body-systems\/nervous-syste\/approach-to-the-comatose-child\/<\/a><\/p>\n<p><em>Nicely structured and practical approach. Definitions of various stats of comatose child. Questions to ask on history, differential diagnosis of comatose child, physical examination findings and management<\/em><\/td>\n<\/tr>\n<tr>\n<td><strong>Avner JR.  Altered States of Consciousness. Pediatrics in Review 2006; 27 (9): 331-338.\nApproach to altered level of consciousness.<\/strong><\/p>\n<p><a href=\"https:\/\/doi.org\/10.1542\/pir.27-9-331\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/doi.org\/10.1542\/pir.27-9-331<\/a><\/p>\n<p><em>Common causes, differential diagnosis, (quite detailed) table on herniation syndromes and management.<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n\t\t\t\t<\/div><\/p>\n<div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Clinical Resources<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><table>\n<tbody>\n<tr>\n<td><strong>Management of the paediatric patient with acute head trauma<\/strong><\/p>\n<p><a href=\"https:\/\/cps.ca\/en\/documents\/position\/acute-head-trauma\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/cps.ca\/en\/documents\/position\/acute-head-trauma<\/a><\/p>\n<p><em>CPS Position Statement<\/em><\/td>\n<\/tr>\n<tr>\n<td><strong>Bottom Line Recommendations: Severe Head Trauma<\/strong><\/p>\n<p><a href=\"https:\/\/cms.trekk.ca\/wp-content\/uploads\/2023\/11\/2022-10-12SevereHeadInjuryBLR_FINAL_v3.0.pdf\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/cms.trekk.ca\/wp-content\/uploads\/2023\/11\/2022-10-12SevereHeadInjuryBLR_FINAL_v3.0.pdf<\/a><\/p>\n<p><em>TREKK Translating Emergency Knowledge for Kids<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n\t\t\t\t<\/div>\n<div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Virtual Patients or Cases<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><table>\n<tbody>\n<tr>\n<td><strong>Case: Altered mental status \u2013 a state of confusion<\/strong><\/p>\n<p><a href=\"https:\/\/doi.org\/10.1093\/pch\/15.5.263\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/doi.org\/10.1093\/pch\/15.5.263<\/a><\/p>\n<p><em>Paediatrics &#038; Child Health, Volume 15, Issue 5, 5\/6 2010, Pages 263\u2013265, https:\/\/doi.org\/10.1093\/pch\/15.5.263<\/em><\/td>\n<\/tr>\n<tr>\n<td><strong>Altered Mental Status Module<\/strong><\/p>\n<p><a href=\"https:\/\/www.saem.org\/about-saem\/academies-interest-groups-affiliates2\/cdem\/for-students\/online-education\/peds-em-curriculum\/approach-to\/altered-mental-status\" target=\"_blank\" rel=\"noopener noreferrer\">https:\/\/www.saem.org\/about-saem\/academies-interest-groups-affiliates2\/cdem\/for-students\/online-education\/peds-em-curriculum\/approach-to\/altered-mental-status<\/a><\/p>\n<p><em>The Society for Academic Emergency Medicine (SAEM) module on Altered Mental Status<\/em><\/td>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n\t\t\t\t<\/div>\n<div class='et-learn-more clearfix'>\n\t\t\t\t\t<h3 class='heading-more'>Cards<span class='et_learnmore_arrow'><span><\/span><\/span><\/h3>\n\t\t\t\t\t<div class='learn-more-content'><table>\n<tbody>\n<tr>\n<td><strong>Altered Level of Consciousness<\/strong><\/p>\n<p><a href=\"https:\/\/cards.ucalgary.ca\/deck\/244\" target=\"_blank\" rel=\"noopener noreferrer\">Altered Level of Consciousness<\/a><\/p>\n<p><em>Canuc-Paeds physician authored, replayable cases<\/em><\/td>\n<\/tr>\n<tr>\n<\/tr>\n<\/tbody>\n<\/table><\/div>\n\t\t\t\t<\/div>[\/et_pb_tab][\/et_pb_tabs][\/et_pb_column][\/et_pb_row][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; fullwidth=&#8221;on&#8221; _builder_version=&#8221;3.19.9&#8243; background_color=&#8221;#eeeeee&#8221; global_module=&#8221;2263&#8243; collapsed=&#8221;on&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_fullwidth_header text_orientation=&#8221;center&#8221; logo_image_url=&#8221;https:\/\/www.pupdoc.ca\/wp-content\/uploads\/2018\/12\/canuc-paeds.png&#8221; _builder_version=&#8221;4.16&#8243; background_color=&#8221;rgba(255, 255, 255, 0)&#8221; background_layout=&#8221;light&#8221; max_width_tablet=&#8221;50px&#8221; custom_padding=&#8221;7px|0px|0px|0px&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;&#8221; custom_padding_last_edited=&#8221;on|phone&#8221; custom_css_main_element=&#8221;max-height: max-content;&#8221; global_colors_info=&#8221;{}&#8221; button_one_text_size__hover_enabled=&#8221;off&#8221; button_two_text_size__hover_enabled=&#8221;off&#8221; button_one_text_color__hover_enabled=&#8221;off&#8221; button_two_text_color__hover_enabled=&#8221;off&#8221; button_one_border_width__hover_enabled=&#8221;off&#8221; button_two_border_width__hover_enabled=&#8221;off&#8221; button_one_border_color__hover_enabled=&#8221;off&#8221; button_two_border_color__hover_enabled=&#8221;off&#8221; button_one_border_radius__hover_enabled=&#8221;off&#8221; button_two_border_radius__hover_enabled=&#8221;off&#8221; button_one_letter_spacing__hover_enabled=&#8221;off&#8221; button_two_letter_spacing__hover_enabled=&#8221;off&#8221; button_one_bg_color__hover_enabled=&#8221;off&#8221; button_two_bg_color__hover_enabled=&#8221;off&#8221;][\/et_pb_fullwidth_header][\/et_pb_section][et_pb_section fb_built=&#8221;1&#8243; _builder_version=&#8221;4.16&#8243; background_color=&#8221;#ffffff&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_row column_structure=&#8221;1_3,1_3,1_3&#8243; _builder_version=&#8221;4.16&#8243; background_size=&#8221;initial&#8221; background_position=&#8221;top_left&#8221; background_repeat=&#8221;repeat&#8221; custom_margin=&#8221;||0px|&#8221; custom_margin_tablet=&#8221;&#8221; custom_margin_phone=&#8221;&#8221; custom_margin_last_edited=&#8221;on|tablet&#8221; custom_padding=&#8221;||0px|&#8221; global_colors_info=&#8221;{}&#8221;][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.16&#8243; background_position=&#8221;top_left&#8221; custom_padding=&#8221;||0px|&#8221; custom_padding_tablet=&#8221;||0px|&#8221; custom_padding_phone=&#8221;||0px|&#8221; custom_padding_last_edited=&#8221;on|desktop&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text module_class=&#8221;menu-clinical-line-height&#8221; _builder_version=&#8221;4.16&#8243; text_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px|&#8221; custom_margin_tablet=&#8221;&#8221; custom_margin_phone=&#8221;&#8221; custom_margin_last_edited=&#8221;on|desktop&#8221; custom_padding=&#8221;||0px|&#8221; custom_padding_tablet=&#8221;&#8221; custom_padding_phone=&#8221;&#8221; custom_padding_last_edited=&#8221;on|phone&#8221; border_style=&#8221;solid&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><a href=\"https:\/\/www.pupdoc.ca\/abdominal-pain-abdominal-mass\/\">Abdominal Pain &amp; Abdominal Mass<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/acutely-ill-child\/\">Acutely Ill Child<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/adolescent-health-issues\/\">Adolescent Health Issues<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/altered-loc\/\"><strong>Altered Level of Consciousness<\/strong><\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/bruising-bleeding\/\">Bruising \/ Bleeding<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/dehydration\/\">Dehydration<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/development-behavioural-learning-problems\/\">Development \/ Behavioural \/ Learning Problems<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/diarrhea\/\">Diarrhea<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/edema\/\">Edema<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/eye-issues\/\">Eye Issues<\/a><\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.16&#8243; background_position=&#8221;top_left&#8221; custom_padding=&#8221;||0px|&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text module_class=&#8221;menu-clinical-line-height&#8221; _builder_version=&#8221;4.16&#8243; text_line_height=&#8221;1.4em&#8221; custom_margin=&#8221;||0px|&#8221; custom_padding=&#8221;||0px|&#8221; custom_css_main_element=&#8221;margin-bottom: 0px !important;&#8221; border_style=&#8221;solid&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><a href=\"https:\/\/www.pupdoc.ca\/fever\/\">Fever<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/genitourinary-complaints\/\">Genitourinary Complaints<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/growth-problems\/\">Growth Problems<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/headache\/\">Headache<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/inadequately-explained-injury\/\">Inadequately explained injury<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/limp-extremity-pain\/\">Limp \/ Extremity Pain<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/lymphadenopathy\/\">Lymphadenopathy<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/mental-health-concerns\/\">Mental Health Concerns<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/murmur\/\">Murmur<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/neonatal-jaundice\/\">Neonatal Jaundice<\/a><\/p>\n<p>[\/et_pb_text][\/et_pb_column][et_pb_column type=&#8221;1_3&#8243; _builder_version=&#8221;4.16&#8243; background_position=&#8221;top_left&#8221; custom_padding=&#8221;|||&#8221; global_colors_info=&#8221;{}&#8221; custom_padding__hover=&#8221;|||&#8221;][et_pb_text module_class=&#8221;menu-clinical-line-height&#8221; _builder_version=&#8221;4.16&#8243; text_line_height=&#8221;1.4em&#8221; border_style=&#8221;solid&#8221; global_colors_info=&#8221;{}&#8221;]<\/p>\n<p><a href=\"https:\/\/www.pupdoc.ca\/newborn\/\">Newborn<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/pallor-anemia\/\">Pallor \/ Anemia<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/rash\/\">Rash<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/respiratory-distress-cough\/\">Respiratory distress \/ Cough<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/seizure-paroxysmal-event\/\">Seizure \/ Paroxysmal event<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/sore-ear\/\">Sore Ear<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/sore-throat-sore-mouth\/\">Sore Throat \/ Sore Mouth<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/vomiting\/\">Vomiting<\/a><br \/><a href=\"https:\/\/www.pupdoc.ca\/well-child-care\/\">Well Child Care<\/a><\/p>\n<p>[\/et_pb_text][\/et_pb_column][\/et_pb_row][\/et_pb_section]<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Head Injury Hypoglycemia Metabolic disease Describe the anatomy and physiology of the central and peripheral nervous systems Describe in basic terms the pathophysiology of brain injury Describe how the brain maintains consciousness, how unconsciousness occurs and the differences between unconsciousness and sleep Name and classify the most common CNS pathogens, based on organism type and [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_et_pb_use_builder":"on","_et_pb_old_content":"","_et_gb_content_width":"","footnotes":""},"class_list":["post-166","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/pages\/166","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/comments?post=166"}],"version-history":[{"count":8,"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/pages\/166\/revisions"}],"predecessor-version":[{"id":2967,"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/pages\/166\/revisions\/2967"}],"wp:attachment":[{"href":"https:\/\/www.pupdoc.ca\/en\/wp-json\/wp\/v2\/media?parent=166"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}