the new
friend assessment consciousness is
of crucial and cavitation acute brain injury
this temple provided the practical guide
to using the common scale that what about Glasco
to ensure reliable assessment and clear communication
about the patient we'll show you how to make
series standard observations 3
aspect the patient responsiveness I opening
bubble and not response stimulation
stephanie's component communicated
according to define criteria to show the degree of impact
present were showing at record and communicate defining
how these can be used and provide you with it down a little Sun
when assessing a patient's
through four steps check observe
stimulate and right the preliminary
check is used to identify any factors that might interfere with your
assessment
in it is important to identify local fighters
such as a hearing impairment text cause electrical capacity to respond
following these preliminary checks we observe the patient
nitty any spontaneous behaviors in any of the three components the scale
ice global home into the patient is rated in each component
by matching findings with a corresponding criterion to four criteria
for eyes
fight for verbal in six minutes cool for each component
the tow criterion is a normal response well slow as criterion is no response
if the patient's eyes open spot
easley spontaneous she quoted remember
the maybe local factors such as swelling to prevent eye opening
his spontaneous evening is not demonstrated verbal stimulus is used by
introducing yourself clearly
requesting I opening if necessary by shouting
dissipation aprons allies to sound is recorded
if the patient does not open the eyes when you speak to them
physical crucial stimulus is then applied
stimulation starts at a low level by pressing on the nail tip
is applied with increasing intensity up to 10 seconds
until the patient demonstrates a response went to Mike Smith stimulus has
been applied
if the
opens our eyes because to pressure
if they do
in their eyes recorders non if their local factors
such as well Inc interfering with an eye-opening we caught
eyes not testable
to assess a verbal response as a patient to tell you the name
where they are what month it is if the answer correctly
record orientated his joining conversation
the patient is able to speak in phrases or sentences but is unable to keep the
crate answers to these questions about orientation
record confused if they do not talk sensibly
with two single words record words
if the patient moans and groans with no recognizable words
record sounds
if the pay
makes no sense at all them accord none
member speech listeners may result from factors
other than to press consciousness for example the presence 7&8 kill cheap
in these cases record they will not testable
to assess
the motor component to the qAME scale for says the patient to perform a
two-step action
by asking them to grasp unleash your fingers with the hand opening the mouth
mistake and it on if the patient does this
record a base commands if the person come with their arms
for example because a spinal injury you should us into open m-f
and stick at it on in a patient who it is not be commands
prefer stimulus alone is inadequate to assess the motor components became a
scale
and an additional central stimulus is needed
this is for supplied by the two pieces pinch
to perform this place your hand if the patient shoulder
can pressure fingers into the muscle above the shoulder blade apply pressure
with increasing intensity
for up to 10 seconds into your show that the response you observe
is a patient's best response
the second location for central stimulus is the supraorbital notch
apply this stimulus if there has been no localizing response to the two pieces
pinch
this stimulus is supplied by placing a hand on the forehead
with the film over the operant the orbits feel for the notch in the Super
ok so margin
apply pressure with increasing intensity for up to 10 seconds
into Europe's if the patient's best response the patient should not be rated
as having
absence of response and to the max more stimulus has been applied
this stimulus should not be used in patients with facial injuries
adjacent to see broke too much
if the patient moves the hand above the clavicle a collarbone
in an attempt to move the stimulus away record
work lies in if they were pulling does not reach but the clavicle
but does flex than they are the normally were abnormally flexing
in clinical practice the assessment of these non localizing sponsors
is based on a combination of both peripheral and central stimulus
in normal flexion they'll be Benz
and the army's rapidly away from the body from the stimulus
in abnormal flexion they ever been slowly
and the on comes across the body if in doubt
we called normal flexion if the patient extends elbows
rosanna flexing them record extension
a patient who makes no responses you quoted as known
if they're paralyzed by other factors such as prices by drokz
record motor not testable on if different responses are exhibited
between limbs
on right and left sides because the better side response
as a best indexes overall responsiveness response to the west side
my reflects focal brain damage a local injury
so to recap check for factors that might interfere with your assessment
who says the patient for spontaneous eye-opening speech
movement if necessary then stimulate the patient
festively and then physically
findings should be documented clearly on a Cayman scale chart
the observations can then be clearly communicated
and the trend rapidly preciate it so the any improvement
or deterioration in a patient's condition can be seen patient ratings
can be documented numerically
as a show Hyundai to quickly report findings when describing the patient
always use a four criteria alongside the numbers
to ensure that the assessment is accurately understood the show had
numbers can also be added together to give a total coma school
this provides an overview summary of the severity of the patient's condition
but this code does not communicate more informative detailed description of each
response
we should always be used in addition to the school in clinical care
of an individual patient ok
this approach to assessment has been drawn together into a structured summary
you can download from the website Glasgow Coma Scale to walk
hey you can also find more information about the use of the Coma Scale
assessment
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