state of consciousness

The general examination of a neurological examination is primarily to examine the patient's state of consciousness. Evaluation is made by talking to the patient and examining the patient's response to external stimuli. The inspected person has a good understanding of himself and his or her surroundings and should include correct time orientation, location orientation and person orientation. When the patient asks questions such as name, age, place, time, etc., the examinee can make a correct answer. When a comatose patient has sputum or secretions and vomit in the mouth, it should be sucked out or sputum in time; each time the patient turns over and changes the patient's position, the back of the patient is gently buckled to prevent the occurrence of inhalation or fallopian pneumonia. Basic Information Specialist classification: neurological examination classification: neuroelectrophysiology Applicable gender: whether men and women apply fasting: not fasting Tips: It is best to be accompanied by a family member before the examination, to appease the emotions for the conscious patients. Normal value Normal people are conscious and have no sleepiness, lethargy, or coma. Clinical significance Abnormal results: The patient's response to external stimuli is slow and dull, suggesting that the brain has lesions. People who need to be examined: patients with lesions in the brain. Precautions Taboo before inspection: 1. It is best to be accompanied by a family member before the examination. It is necessary to appease the emotions for patients who are conscious. 2. When a comatose patient has sputum or secretions and vomit in the mouth, it should be sucked out or pulled out in time; each time the patient turns over and changes the patient's position, the patient's back is gently buckled to prevent the occurrence of inhalation or fallopian pneumonia. 3, pay attention to keep warm to comatose patients, to prevent cold. Requirements for inspection: 1, to make the coma patient supine, head side to one side, in order to keep the airway smooth. 2, coma patients have active dentures, should be removed immediately to prevent accidental entry into the trachea. 3. Prevent falling of the bed. Patients who are restless should install a bed block and use a protective tape if necessary to prevent the patient from falling into bed or falling. Inspection process 1. Clear-headed state The examinee has good knowledge of himself and his surroundings and should include correct time orientation, location orientation, and person orientation. When the patient asks questions such as name, age, place, time, etc., the examinee can make a correct answer. 2. A form of consciousness disorder in which the somnolence state is reduced in consciousness. Refers to the patient's awareness of a lesser degree of awakening, call or push the patient's limbs, the patient can be awake immediately, and can make some short and correct conversations or do some simple actions, but the stimulus disappears and falls asleep. At this time, the patient's swallowing, pupil, cornea and other reflections exist. 3. Confusion refers to the degree of patient's disturbance of consciousness is deeper than lethargy, can not clearly understand external stimuli; spatial and temporal dynamism; understanding, retardation, or error; memory blur, near memory is worse The impression of the real environment is ambiguous, often inconsistent in thinking, and slow in thinking activities. In general, when a patient has time and place disorientation, it is called confusion. 4. The state of stupor state is reduced in consciousness and deeper than the state of consciousness. Shouting or pushing the limbs does not cause a reaction. When a patient is pressed with a finger to press the inside of the upper edge of the patient, the patient's facial muscles (or acupuncture of the patient's hands and feet) can cause defensive reflexes. At this time, deep reflection hyperactivity, tremor and involuntary movement, cornea, eyelash and other reflections are weakened, but the light reflection still exists. 5. Superficialcoma refers to the loss of voluntary movement of the patient, which should not be responded to, and has no response to general stimulation. It responds to strong painful stimuli such as compression and compression, shallow reflection disappears, tendon reflex, and pharyngeal reflex The corneal reflex and the pupil reflect the light, and there is no obvious change in the breathing and pulse. Found in severe cerebrovascular disease, encephalitis, brain abscess, brain tumor, poisoning, early shock, hepatic encephalopathy. 6. Deep coma (deepcoma) means that the patient has no response to various stimuli, completely in a stationary position, corneal reflex and pupil reflex to light, incontinence, irregular breathing, blood pressure drop, at this time may go Brain rigidity. In the later stage, the patient's muscles were slack, the eyeballs were fixed, the pupils were scattered, and they were dying. Found in hepatic encephalopathy, pulmonary encephalopathy, cerebrovascular disease, brain tumor, brain trauma, severe poisoning, late shock and so on. Not suitable for the crowd Inappropriate people: not yet known. Adverse reactions and risks Nothing.