Altered states of consciousness can have many different causes in children and adolescents, such as fever, hypoglycaemia, encephalitis or meningitis, sunstroke, heatstroke and more. Further causes can be traumatic brain injury or intoxication. In adolescent patients, drug or alcohol consumption should be considered. The maximum altered state of consciousness is unconsciousness.

Symptoms are

• Confusion
• Sleepiness
• Drowsiness, apathy
• Nausea / vomiting in case of intoxications
• Unconsciousness: no reaction to painful stimuli

First Aid Measures

• Dial the emergency number 144 (get someone else to call)
• Lay the child down
• Unconscious child with normal breathing: place on the side in a lateral security position
• Infant: prone position (on the stomach), angled, slightly extended head
• In case of suspected hypoglycaemia: administration of sugar
• In case of suspected sun- or heatstroke: place the child under shade, cool the head and neck region
• Continuous monitoring of breathing
• Unconscious patient with a traumatic mechanism of injury with normal breathing: apply manual inline stabilisation

Also note

Altered states of consciousness always represent an alteration of brain function and are thus an emergency.

In the case of an unconscious child with suspected hypoglycaemia: give sugar (in gel or powder form), applying the sugar on the inside lining of the cheek pouches.

In case of interruption of breathing: immediately start cardiopulmonary resuscitation.