The Altered conscious state CPG has been updated and reviewed by the CPG committee and endorsed by the Paediatric Improvement Collaborative (December 2022). This CPG replaces the previous Coma CPG and it covers the continuum of altered conscious state, from disorientation and confusion to coma.  

CPG key points  

1. The aim of immediate management is to minimise ongoing neurological damage while investigation and treatment are initiated 
2. Parents are the best judge of an altered conscious state, particularly for children with disability 
3. Consider child abuse in a young child presenting with altered conscious state and signs of injury