Glasgow Coma Scale
The Glasgow Coma Scale (GCS) is a neurological assessment scale which aims to give a reliable, objective way of quantifying level of consciouness following a traumtic brain injury. [[1]]
The Glasgow Coma Score is also used as part of the APACHE II assessment score for Critical Care and the MOST assessment score for Medicine.
- Select the BEST Eye, Motor or Verbal response in the first 24 hours of ICU admission.
The possible values are stored as dropdown lists on your PDA and in Access are as follows:
| Score | 6 | 5 | 4 | 3 | 2 | 1 |
| Best EYE Response | Spontaneous | To
Speech |
To
Pain |
None | ||
| Best MOTOR Response | Obeys
Command |
Localizes
Pain |
Withdraws
to Pain |
Abnormal
Flexion |
Abnormal
Extension |
None |
| Best VERBAL Response | Oriented | Confused | Inappropriate
words |
Incomprehensible
sounds |
None | |
| Best VERBAL Response -Venilated | 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 can communicate in writing should be coded as functioning normally for Verbal assessment.
- 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. 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. 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 prior to sedation or paralysis 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.
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)Use GSC to assess brain injury. 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?