A rapid neurological assessment should occur as a part of the primary survey to assess conscious state. Inadequate oxygenation caused by smoke inhalation and toxins may affect conscious state.
KEY STEPS:
- Assess consciousness.
- Check blood glucose.
Assess Consciousness
Perform a rapid neurological assessment using the AVPU mnemonic:
A – Alert
V – Responding to Verbal stimuli
P – Responding to Painful stimuli
U – Unresponsive
Examine pupils are responding appropriately to light.
An altered level of consciousness indicates the need for repeated evaluation of the patient’s oxygenation, ventilation, and perfusion status. A comprehensive Glasgow Coma Scale will be completed as a part of the secondary survey
Check blood glucose levels
Rule out metabolic cases of altered consciousness, such as diabetes. Ensure that any alterations in level of consciousness are not related to a metabolic cause.