When a child presented with decreased level of consciousness in the emergency room, taking the right approach is one of the most important skills that every emergency physician should have. Ideally, there should be a defined diagnostic and therapeutic algorithm in the emergency room for managing these children in order to minimize difficulties diagnostically and maximize time spent helping the child. This article describes the history-taking, and physical and neurologic exams the affected child should be assessed with and explains the potential etiologies of a decreased level of consciousness. These factors are classified into traumatic and non-traumatic agents. Infectious causes of encephalopathy and the applied classification of them has been emphasized.
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