I know it's 14 years later that the comment was posted but I just listened to the podcast. I made detailed, transcript-style notes I will share for those who are also looking for a complete script:

*Start of notes*
4. Management
a) Approach to a child with an acute change in LOC: ABCDEFG approach (+ Chem strip for glucose)
b) Look for signs of herniation syndrome: pupil changes, asymmetric or absent EOM, abnormal motor responses to pain stimuli (e.g., decerebrate and decorticate posturing are abnormal to noxious stimuli, associated with pathologies such as stroke)
—> if there is a herniation syndrome, patient would need endotracheal intubation, mechanical ventilation, neurosurgery STAT
—> also get IV access
c) If no herniation, get bloods + do surveys for life-threatening issues
-labs: serum glucose, blood gas, electrolytes, renal function, liver function, CBC + diff, blood and urine cultures, urine and serum toxicology screen; also serum osmolality, serum ammonia, serum lactate.
+ in infant/toddler, consider a metabolic disorder to consider in an infant and toddler
-ensure glucose is running; IV dextrose (e.g., D10 or D12.5%, hold proteins); don’t forget b/c certain pathologies can cause irreversible neurologic dysfunction
-if serum glucose is normal, look for opioid toxicity; if positive, IV naloxone
d) Detailed neurologic and general exam
-Look for focal neurologic signs, which tends to occur with structural causes. usually no focal medical signs in medical causes but there are exceptions
—> always do a GCS
-Vital signs are important
-General exam
—> fever: suggests CNS infection as a cause, also seen in some kinds of toxic ingestion
—> respiratory rate + pattern
—> pulse or BP can be abnormal in herniation syndromes
—> petechiae and purpura (w/ fever, suggest meningiocccaemia but without fever suggest bleeding tendency or trauma and by extension, an intercerebral bleed
—> infants: examine fontanelles to see if bulging or sunken
—> if impaired cough and gag reflex, require endotracheal intubation
—> if GCS less than 8, consider intubation
e) Imaging
-Consider neuroimaging: CT scan
—> MRI has advantages but limited by availability and logistic concern
f) Look for signs of increased ICP and perform a LP
—> make sure: if no ICP inc, no bleeding dysfunction, and stable child, then can do LP
—> How to look for signs of increased ICP: increased ICP on exam or neuroimaging, determined by the cushing response which is hypertension, bradycardia, impaired consciousness. accompanied by altered respiration often
—> papilledema often a better indicator for chronic increase in ICP
6. Common causes of altered levels of consciousness
-poisoning/toxic ingestion extremely common
—> toddlers, generally accidental. adolescents, generally intentional
—> suspect possibility of toxic ingestion especially in afebrile children; often unable to elicit a history
—> onset of symptoms tend to occur gradually over hours or days
—> ask about all OTC and prescription medications in the home, not just the ones they think they could have accessed
—> ask about amount (how much left in the pills to estimate maximum ingestion), when ingestion happened, and where
-trauma is more common throughout childhood
—> can have focal neurologic signs, but others there are no focal neurological signs
—> can have accidental or intentional. most commonly accidental but evaluate if mechanism is consistent w/ history
—> consider child abuse for any infant with an altered levels of consciousness. In shaken baby syndrome: CT shows subdural haematoma and diffuse cerebral oedema. retinal haemorrhages may be visible. can be mimicked by falls greater than 3 stories or high-speed vehicle motor accidents
-meningitis and encephalitis: often the culprit in altered levels of consciousness
—> presentation can be subtle; fever and irritability may be the main complaints so be diligent in looking for them
—> shoudl be suspected in the case of fever, leukocytosis
—> dx with CSF exam. empiric abx immediately if unstable or if there are focal neurologic signs
—> if herpes encaphalitis is a concern, antivirals should be taken
—> remember west nile, varicella, or influenza as causes of encephalitis
-seizures/shock can also present
—> can also present as altered levels of consciousness
—> you would have picked up on shock while taking care of the ABCDEFGs
-metabolic causes
—> inborn errors of metabolism often in infancy. DKA is the most common condition that causes altered levels of consciousness and can present in any age
—> hepatic and renal failure can also cause metabolic encepalopathy. on exam, may notice movements disorders like asterixis, tremor, or myoclonus w/ metabolic causes.
7. Take home points
a) Remember approach: structural vs metabolic
b) ABCDEFG and re-assess
c) Glucose can be lifesaving and prevent irreversible neurologic damage
d) Early neuroimaging can be important to r/o shaken baby syndrome (could require neurosurgical interventions)
e) Rapid-onset of symptoms without fever is toxic ingestion until proven otherwise

*End of notes*

I hope it helps!
Monica