Glasgow Coma Scale
The Glasgow Unconsciousness Scale, modified for children, is used to assess the state of consciousness . To assess the state of consciousness in children under 3 years of age , the Best Possible Coma Score scale is developed based on the assessment of maximum abilities with respect to maturation ( Reilly et al. ).
The scale helps to assess the patient's state of consciousness and the changes that occur during hospitalization.
The resulting score is created by the sum of three values, where each numerical value corresponds to the highest achieved degree of the patient's response to a given stimulus. (The score may be skewed by associated diseases or disorders of the patient, it does not evaluate the lateralization of symptoms.)
Scale[edit | edit source]
| eye opening | adults and older children | little children |
|---|---|---|
| 1 | does not open | does not open |
| 2 | open by pain | open by pain |
| 3 | open by voice | open by voice |
| 4 | open spontaneously | open spontaneously |
| Verbal response | ||
| 1 | none | none |
| 2 | incomprehensible sounds | moans by painful stimuli |
| 3 | individual words | shouts or cry by painful stimuli |
| 4 | inadequate speech | screams spontaneously, cries, inappropriate reactions |
| 5 | adequate speech | hums, yells, watches the surroundings, turns to the sound |
| Motor response | ||
| 1 | none | none |
| 2 | non-specific extension at the site of painful stimuli | non-specific extension at the site of painful stimuli |
| 3 | non-specific stimulation by painful stimuli | non-specific stimulation by painful stimuli |
| 4 | escape reaction by a painful stimulus | escape reaction by a painful stimulus |
| 5 | targeted defense response to a painful stimulus | targeted defense response to a painful stimulus |
| 6 | adequate motor response | normal spontaneous mobility |
| Evaluation | ||
| 15–13 | no or mild failure | |
| 9–12 | moderate disorder | |
| up to 8 | serious disorder |
Evaluation[edit | edit source]
- GCS values can only range from 15 to 3 . For a rough assessment of the patient's condition, the disorder of consciousness can be divided into three stages:
- mild (GSC 15–13),
- intermediate (GSC 12–9),
- severe (GSC 8–3) impaired consciousness.
- In order to correctly determine the score, it is necessary to reflect in the evaluation of other comorbidities that affect the result of the evaluation, but are not a manifestation of a disorder of consciousness. We do not evaluate localized pathologies, but the overall condition of the CNS. E.g. Of course, GCS 15 is also achieved by a quadruplegic patient with expressive aphasia, although this does not seem so at first glance. In contrast, muscle relaxation, intubation or analgesia make evaluation impossible.
- GCS assessment should be performed at the first contact with the patient, especially in conditions related to CNS and conscious damage.
Calculation[edit | edit source]
MediaWiki:Lékařská kalkulačka/GCS We are currently working on a medical calculation.
Source[edit | edit source]
[edit | edit source]
- Consciousness and its disorders
- Acute Conditions in Neurology and Disorders of Consciousness
- Apallic syndrome
- Vigilance
- Lucidity
- Unconsciousness
- General examination of the patient
External links[edit | edit source]
Source[edit | edit source]
- BENEŠ, Jiří. Studijní materiály [online]. [cit. 25.10.2011]. <http://jirben.wz.cz>.
Reference[edit | edit source]
- ↑ STAŇKOVÁ, M. České ošetřovatelství 6 – Hodnocení a měřící techniky v ošetřovatelské praxi. 1. edition. Brno : Institut pro další vzdělávání pracovníků ve zdravotnictví, 2000. ISBN 80-7013-323-6.
- ↑ ROWLETT, Russ. How Many? A Dictionary of Units of Measurement [online]. ©2001. The last revision 2001-07-30, [cit. 2009-10-28]. <http://www.unc.edu/~rowlett/units/scales/glasgow.htm>.
