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Response to Painful Stimuli

Profound sedation in the presence of a reasonable blood pressure suggests TCAs, neuroleptics, anticonvulsants (e.g. carbamazepine, phenytoin), opioids or barbiturates.

It is unusual for benzodiazepines or alcohol alone to lead to deep coma (grades 2-4). More serious toxins such as TCAs and anticonvulsants are more likely.

Alert no signs of CNS depression
Drowsy all patients between alert & stuporous
Stuporous responds to verbal or tactile stimuli
Coma 1 responds to painful stimuli only, normal BP & Respiration
Coma 2 no response to painful stimuli, normal BP & Respiration
Coma 3 no response to painful stimuli, abnormal respiratory pattern &/or low but adequate BP
Coma 4 no response to painful stimuli, apnoea or inadequate respiration &/or inadequate BP

Plum F, Posner JB. The diagnosis of stupor and coma. Contemp Neurol Ser 1972;10:1-286 PMID4664014

wikitox/response_to_painful_stimuli.txt · Last modified: 2018/09/01 09:01 by

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