Epidemiology

The epidemiology of coma in emergency departments has been little studied. Current estimate is that acute unresponsiveness is present in 0.5 to 1 percent of ED admissions, but that may vary depending on referral patterns, trauma volume, and toxicology volume of different institutions. The only paper addressing frequency of coma in the ED dates from 1934 and is of historic interest because it predates modern EMS and advanced life support procedures. In that 1934 study, 3 percent of the patients presented to the hospital in coma.18 Some of the common causes of coma then as now were alcohol intoxication, trauma, cerebrovascular disease, poisoning, meningitis, and cardiopulmonary failure (T§ble..,.221-.8.). One striking difference was the lack of hypoglycemia; insulin therapy was not in widespread use at that time.

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