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Is Immediate Neurological Treatment Necessary When A Diabetic, Sleep Apnea Patient Is Unconscious?
Question: Hi I just learned my daughter in law who is on the other side of the country has been taken to the hospital unconscious. She is a diabetic taking meds for it but I am not sure what. She like to drink and my son said they were out drinking last evening. I don't know how much. She also has sleep apnea and uses a machine to help her breathing. She is also obese.. She did not wake up this morning so my son is with her in hospital and very worried. She still has not awakened since last night since she went to bed. She is in a very small hospital and I wonder if she should be taken to a better hospital. She is in Heart Florida hospital in XXXXXXX They are not too far from XXXXXXX What would you do?
Brief Answer:
Neurology facility/Brain imaging/Blood sugar/EEG
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
In this scenario,your daughter in law must urgently be taken to a hospital with a well established 'neurology facility with ICU'.
She urgently needs-
1)Neurological examination-to look out for the possible cause of unconsciousness.
2)Brain imaging-Stroke is a strong possibility.She urgently needs CT scan of brain to rule out stroke.CT scan may be followed by MRI Brain depending on the results.
3)Alcohol intoxication-Because alcohol intoxication is a possibility,so she needs to be screened for hypoglycemia and may need dextrose with thiamine i.v infusion.
4)Airway and fluids-She must be monitored for any respiratory depression and patency of airway must be ensured.Fluids balance must be taken care of.
5)EEG-Seizure remains a strong possibility as well.EEG is a must to do.Empirical antiepileptics may also be started.
6)Metabolic and hematologic screening-Blood sugar,serum electrolytes,kidney and liver function tests,serum ammonia,thyroid function tests should be done to screen all potential causes for unconsciousness.Hemogram should be done and watched for any indicator of infection or other abnormalities.
All the above measures are possible at a place with clinical and critical neurology setting.
If you have some further questions,I shall be glad to answer.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Neurology facility/Brain imaging/Blood sugar/EEG
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
In this scenario,your daughter in law must urgently be taken to a hospital with a well established 'neurology facility with ICU'.
She urgently needs-
1)Neurological examination-to look out for the possible cause of unconsciousness.
2)Brain imaging-Stroke is a strong possibility.She urgently needs CT scan of brain to rule out stroke.CT scan may be followed by MRI Brain depending on the results.
3)Alcohol intoxication-Because alcohol intoxication is a possibility,so she needs to be screened for hypoglycemia and may need dextrose with thiamine i.v infusion.
4)Airway and fluids-She must be monitored for any respiratory depression and patency of airway must be ensured.Fluids balance must be taken care of.
5)EEG-Seizure remains a strong possibility as well.EEG is a must to do.Empirical antiepileptics may also be started.
6)Metabolic and hematologic screening-Blood sugar,serum electrolytes,kidney and liver function tests,serum ammonia,thyroid function tests should be done to screen all potential causes for unconsciousness.Hemogram should be done and watched for any indicator of infection or other abnormalities.
All the above measures are possible at a place with clinical and critical neurology setting.
If you have some further questions,I shall be glad to answer.
Regards
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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