Disability is the fifth clinical assessment in the Primary survey, looking at the conscious level of the patient and what deficits may be affecting their level of consciousness. A reduced level of consciousness can have multiple negative affects on the patient, from putting them in situational danger, affecting the patency of their airway, and diminishing their ability to respond to circumstances around them. The cause of their reduced consciousness could also have significant life-threatening effects, such as traumatic brain injury, stroke, Addison’s disease, and more. Trying to identify the reason for the reduced level of consciousness could help in the patients’ overall treatment and allow you to effectively reverse the deficit or transfer to further care, for example, an unconscious hypoglycaemic patient receiving glucose to reverse their abnormal blood sugar state. In this section we will explore a number of pathophysiological issues and their management relating to reduced level of consciousness.

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