Neurocritical Care

, Volume 17, Supplement 1, pp 54–59 | Cite as

Emergency Neurological Life Support: Approach to the Patient with Coma

  • J. Stephen HuffEmail author
  • Robert D. Stevens
  • Scott D. Weingart
  • Wade S. Smith
Review Article


Coma is an acute failure of neuronal systems governing arousal and awareness and represents a neurological emergency. When encountering a comatose patient, the clinician must have an organized approach to detect easily remedial causes, prevent ongoing neurologic injury, and determine a hierarchy of diagnostic tests, treatments, and neuromonitoring. Coma was chosen as an Emergency Neurological Life Support (ENLS) protocol because timely medical and surgical interventions can be life-saving, and the initial work-up of such patients is critical to establishing a correct diagnosis.


Coma Herniation Osmolar therapy Mannitol Hypertonic saline 


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Copyright information

© Neurocritical Care Society 2012

Authors and Affiliations

  • J. Stephen Huff
    • 1
    Email author
  • Robert D. Stevens
    • 2
  • Scott D. Weingart
    • 3
  • Wade S. Smith
    • 4
  1. 1.Departments of Emergency Medicine and NeurologyUniversity of Virginia School of MedicineCharlottesvilleUSA
  2. 2.Departments of Anesthesiology and Critical Care Medicine, Neurology, Neurosurgery, and RadiologyJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Division of ED Critical CareMount Sinai School of MedicineNew YorkUSA
  4. 4.Department of NeurologyUniversity of California, San FranciscoSan FranciscoUSA

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