GLASGOW COMA SCALE

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Slide 1: 

CNE PRESENTATION VAATSALYA HOSPITAL WELCOME TO BY GLASGOW COMA SCALE

Slide 2: 

PRESENTED BY EDWIN

The Glasgow Coma Scale or GCS : 

The Glasgow Coma Scale or GCS INTRODUCTION The Glasgow Coma Scale or GCS, sometimes also known as the Glasgow Coma Score is a neurological scale which aims to give a reliable, objective way of recording the conscious state of a person, for initial as well as continuing assessment. A patient is assessed against the criteria of the scale, and the resulting points give a patient score between 3 (indicating deep unconsciousness) and either 14 (original scale) or 15 (the more widely used modified or revised This scle was published in 1974 two professors of neurosurgery Graham and Bryan at Glasgow University

GCS was initially used to assess level of consciousness : 

GCS was initially used to assess level of consciousness after head injury, and the scale is now used by first aid, EMS and doctors as being applicable to all acute medical and trauma patients. In hospital it is also used in chronic patient monitoring, in for instance, intensive care.

Best eye response (E) : 

Best eye response (E) There are 4 grades starting with the most severe: No eye opening Eye opening in response to pain. (Patient responds to pressure on the patient’s fingernail bed; if this does not elicit a response, supraorbital and sternal pressure or rub may be used.) Eye opening to speech. (Not to be confused with an awaking of a sleeping person; such patients receive a score of 4, not 3.) 4. Eyes opening spontaneously

Best verbal response (V) : 

Best verbal response (V) There are 5 grades starting with the most severe: No verbal response Incomprehensible sounds. (Moaning but no words.) Inappropriate words. (Random or exclamatory articulated speech, but no conversational exchange) Confused. (The patient responds to questions coherently but there is some disorientation and confusion.) Oriented. (Patient responds coherently and appropriately to questions such as the patient’s name and age, where they are and why, the year, month, etc.)

Best motor response (M) : 

Best motor response (M) There are 6 grades starting with the most severe: No motor response Extension to pain (adduction of arm, internal rotation of shoulder, pronation of forearm, extension of wrist, decerebrate response) Abnormal flexion to pain (adduction of arm, internal rotation of shoulder, pronation of forearm, flexion of wrist, decorticate response) Flexion/Withdrawal to pain (flexion of elbow, supination of forearm, flexion of wrist when supra-orbital pressure applied ; pulls part of body away when nailbed pinched) Localizes to pain. (Purposeful movements towards painful stimuli; e.g., hand crosses mid-line and gets above clavicle when supra-orbital pressure applied.) Obeys commands. (The patient does simple things as asked.)

Itubation and sever facial/eye swelling or damage, make it impossible to test the verbal and eye responses.In this circumstances the score is given as 1 with modifier attached e.g ‘Elc’ where C=closed ‘V1t where t= Tube : 

Itubation and sever facial/eye swelling or damage, make it impossible to test the verbal and eye responses.In this circumstances the score is given as 1 with modifier attached e.g ‘Elc’ where C=closed ‘V1t where t= Tube

Generally, comas are classified as: : 

Generally, comas are classified as: Severe, with GCS = 8 Moderate, GCS 9 - 12 Minor, GCS = 13. Deep coma score 3 Normal score 15

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THANK YOU

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QUESTIONS ?