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Coma Scales. The primary goal of the neurologic examination in an unresponsive patient is to localize the lesion and thereby narrow the differential diagnosis. The examination should proceed in a stepwise fashion and be familiar to the neurologist because of constant repetition.
Cardiac tamponade. extracardiac obstructive shock. mechanical obstruction to cardiac filling. pressures of the right cardiac chambers, the pulmonary artery, and the left cardiac chambers equilibrate in diastole. always consider cardiac tamponade when the CVP is high and BP low. pulsus paradoxus.