The document discusses altered states of consciousness and coma. It defines coma as a state where the patient is unrousable and unresponsive to external stimuli. The Glasgow Coma Scale is used to grade comas, with lower scores indicating deeper comas where death is more likely. Common causes of comas include head injuries, infections, metabolic disorders, toxins, and more. Immediate assessment focuses on airway, breathing, circulation, blood tests, and the Glasgow Coma Scale. Further steps to identify the cause include detailed history, exam, and investigations. Management aims to treat the underlying cause and provide supportive care. Brain death criteria require absence of brain stem reflexes and respiratory effort without life support.

2. Altered consciousness and coma By Dr. Osman Sadig Bukhari