Clinical Case Database / Category: Clinical Care

Management and investigation of coma on a post-operative patient

Publication details

Dr Kok Hooi Yap, Dr Martin Clark
Foundation Years Journal, volume 4, issue 3, p.36 (123Doc Education, London, March 2010)


This case-based discussion focuses on an independent 73-year-old lady presenting with coma 6 days after a right total hip replacement. The management of coma is discussed with emphasis on the acute resuscitation and differential diagnosis. This complex case demonstrates that using a systematic and multidisciplinary approach allows appropriate management of a patient even when the aetiology is unknown.

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Dr Kok Hooi Yap

Foundation Year 1
Royal Infirmary of Edinburgh
51 Little France Crescent
Old Dalkeith Road
Edinburgh EH16 4SA

Dr Martin Clark

Consultant Anaesthetist and Intensive care
Intensive Care Unit
Queen Margaret Hospital
Fife KY12 0SU


1. Venkatesh B (2009) Disorders of Consciousness. In: Ad Bersten, N Soni. Oh's Intensive Care Manual, 6th edn. Philadephia: Butterworth-Heinemann, 525–540.
2. Chapter 7, Neurological Emergencies. In: B Chapman, C Kelly, S Maxwell, M Mckechnie, G Nimmo, M Naysmith, et al. (2007) Adult Medical Emergencies Handbook, 4th edn. Lothian Health: University Hospitals Division, 221–223.


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About the Clinical Cases Database

T​he Foundation Years Clinical Cases Database is​ a selection of 600 peer-reviewed clinical cases in the field of patient safety and clinical practice, specifically focused on the clinical information needs of junior doctors, based around the Foundation Year Curriculum programme (MMC). The cases have been chosen to align with the Foundation Year Curriculum.

The database is fully searchable, or can be browsed by medical specialty. Abstracts can be read free of charge, however a subscription is required in order to read the complete cases.