Glasgow Coma Scale: Difference between revisions
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* (there is a case of patients LOC reduced due to meds and how that should be coded normal as well - details anyone?) | * (there is a case of patients LOC reduced due to meds and how that should be coded normal as well - details anyone?) | ||
**For non neuro and post operative patient who are sedated or paralyzed, record a NORMAL GSC score unless there are concerns in regards brain injury of some sort. | **For non neuro and post operative patient who are sedated or paralyzed, record a NORMAL GSC score unless there are concerns in regards brain injury of some sort. Sedation does not allow us to accurately assess neuological status therefore we use alternative information that was documented prior to OR or sedation or we use our "best guess" based on chart notes. | ||
*** I think that one might weave back and forth too much and be a bit hard to read. How about this: | *** I think that one might weave back and forth too much and be a bit hard to read. How about this: | ||
Being sedated or paralyzed may not allow us to accurately assess neurological status. For '''sedated''' or '''paralyzed''' patients consider their likely neurological status once prior to sedation or paralyzis or status when sedation wears off. | |||
* | * when using information that was '''documented prior to sedation/paralysis''' or POST OP use "best guess" based on chart notes | ||
* if there is any sign of '''brain injury''', score '''<how>''' | * if there is any sign of '''brain injury''', score '''<how>''' | ||
Even if my version is not adopted, we do need to state how to score in case of brain injury. [[User:Ttenbergen|Ttenbergen]] 17:15, 18 June 2008 (CDT) | Even if my version is not adopted, we do need to state how to score in case of brain injury. [[User:Ttenbergen|Ttenbergen]] 17:15, 18 June 2008 (CDT) | ||
Revision as of 11:49, 2008 June 23
The Glasgow Coma Scale is a ... [1]
The Glasgow Coma Scale is used to calculate the APACHE II score and the MOST score.
The possible values stored as dropdown lists on your PDA and in Access are as follows:
| Score | 6 | 5 | 4 | 3 | 2 | 1 |
| Eyes | Spontaneous | To
Speech |
To
Pain |
None | ||
| Motor | Obeys
Command |
Localizes
Pain |
Withdraws
to Pain |
Abnormal
Flexion |
Abnormal
Extension |
None |
| Verbal | Oriented | Confused | Inappropriate
words |
Incomprehensible
sounds |
None | |
| Verbal vented | Appears Oriented | ? Oriented | No response |
Special Cases
- For patients whose ability to communicate are reduced due to pre-existing conditions, score as fully functioning if they are able to function at the level that is normal for this patient. (e.g. Down's syndrome)
- Patients who are aphasic or intubated but clearly responsive or can communicate in writing should be coded as functioning normally.
- (there is a case of patients LOC reduced due to meds and how that should be coded normal as well - details anyone?)
- For non neuro and post operative patient who are sedated or paralyzed, record a NORMAL GSC score unless there are concerns in regards brain injury of some sort. Sedation does not allow us to accurately assess neuological status therefore we use alternative information that was documented prior to OR or sedation or we use our "best guess" based on chart notes.
- I think that one might weave back and forth too much and be a bit hard to read. How about this:
- For non neuro and post operative patient who are sedated or paralyzed, record a NORMAL GSC score unless there are concerns in regards brain injury of some sort. Sedation does not allow us to accurately assess neuological status therefore we use alternative information that was documented prior to OR or sedation or we use our "best guess" based on chart notes.
Being sedated or paralyzed may not allow us to accurately assess neurological status. For sedated or paralyzed patients consider their likely neurological status once prior to sedation or paralyzis or status when sedation wears off.
- when using information that was documented prior to sedation/paralysis or POST OP use "best guess" based on chart notes
- if there is any sign of brain injury, score <how>
Even if my version is not adopted, we do need to state how to score in case of brain injury. Ttenbergen 17:15, 18 June 2008 (CDT)
Template:Discussion
Discussion
- proper entry required in "special cases" for (there is a case of patients LOC reduced due to meds and how that should be coded normal as well - details anyone?) Ttenbergen 14:14, 18 June 2008 (CDT)
- How do we classify drug overdoses,when the outcome isn't clear?