When someone starts acting differently in terms of how alert or awake they are, it can be a tough situation for emergency (ER) department doctors.e exact and definitive etiologies of ALOC that can be intracranial or extracranial.

The change in terms of mental state in accordance with how alert and awake patient is termed as altered level of consciousness. Etiologies will be classified by using convenience sampling. GCS<14 patients will be included in this study. Data will be collected through a slight modification in a pre-designed Performa. Reference point for the data collection will be the time of discharge from the emergency department. In Previous studies mostly, etiologies were classified as extracranial and intracranial. Some studies found neurological etiologies most dominant as an extra cranial and some studies found systematic infections ,metabolic causes and some demonstrated that intracranial etiologies were dominant. So, in this study we will find the definitive diagnosis in patient having ALOC which can be intracranial or extracranial. And also, it will be compared with GCS scale. This study will identify th

Inclusion Criteria:

• Patients with GCS<15, age group 18 years to 90 years which come in emergency department due to any etiology will be included in this study.

Exclusion Criteria:

• GCS = 15 will be excluded from the study.
• patients coming in any outpatient department setting or other than emergency department and age group <18 or > 90 will be excluded from this study.

Definitive Diagnosis and Patient Outcomes in Altered Level of Consciousness in the Emergency Department