1
00:00:04,750 --> 00:00:10,440
the new

2
00:00:10,439 --> 00:00:14,459
friend assessment consciousness is

3
00:00:14,460 --> 00:00:18,320
of crucial and cavitation acute brain
injury

4
00:00:18,320 --> 00:00:21,990
this temple provided the practical guide

5
00:00:21,989 --> 00:00:25,419
to using the common scale that what
about Glasco

6
00:00:25,420 --> 00:00:29,949
to ensure reliable assessment and clear
communication

7
00:00:29,949 --> 00:00:33,730
about the patient we'll show you how to
make

8
00:00:33,729 --> 00:00:37,049
series standard observations 3

9
00:00:37,049 --> 00:00:40,709
aspect the patient responsiveness I
opening

10
00:00:40,710 --> 00:00:44,009
bubble and not response stimulation

11
00:00:44,009 --> 00:00:48,149
stephanie's component communicated

12
00:00:48,149 --> 00:00:52,030
according to define criteria to show the
degree of impact

13
00:00:52,030 --> 00:00:56,268
present were showing at record and
communicate defining

14
00:00:56,268 --> 00:01:02,640
how these can be used and provide you
with it down a little Sun

15
00:01:02,640 --> 00:01:04,170
when assessing a patient's

16
00:01:04,170 --> 00:01:07,469
through four steps check observe

17
00:01:07,469 --> 00:01:10,750
stimulate and right the preliminary

18
00:01:10,750 --> 00:01:14,478
check is used to identify any factors
that might interfere with your

19
00:01:14,478 --> 00:01:15,239
assessment

20
00:01:15,239 --> 00:01:18,369
in it is important to identify local
fighters

21
00:01:18,370 --> 00:01:22,359
such as a hearing impairment text cause
electrical capacity to respond

22
00:01:22,359 --> 00:01:26,140
following these preliminary checks we
observe the patient

23
00:01:26,140 --> 00:01:30,359
nitty any spontaneous behaviors in any
of the three components the scale

24
00:01:30,359 --> 00:01:35,280
ice global home into the patient is
rated in each component

25
00:01:35,280 --> 00:01:39,189
by matching findings with a
corresponding criterion to four criteria

26
00:01:39,189 --> 00:01:39,929
for eyes

27
00:01:39,930 --> 00:01:44,520
fight for verbal in six minutes cool for
each component

28
00:01:44,519 --> 00:01:51,519
the tow criterion is a normal response
well slow as criterion is no response

29
00:01:53,810 --> 00:01:55,450
if the patient's eyes open spot

30
00:01:55,450 --> 00:01:59,009
easley spontaneous she quoted remember

31
00:01:59,009 --> 00:02:03,659
the maybe local factors such as swelling
to prevent eye opening

32
00:02:03,659 --> 00:02:07,849
his spontaneous evening is not
demonstrated verbal stimulus is used by

33
00:02:07,849 --> 00:02:09,460
introducing yourself clearly

34
00:02:09,460 --> 00:02:13,060
requesting I opening if necessary by
shouting

35
00:02:13,060 --> 00:02:17,250
dissipation aprons allies to sound is
recorded

36
00:02:17,250 --> 00:02:20,469
if the patient does not open the eyes
when you speak to them

37
00:02:20,469 --> 00:02:24,479
physical crucial stimulus is then
applied

38
00:02:24,479 --> 00:02:27,750
stimulation starts at a low level by
pressing on the nail tip

39
00:02:27,750 --> 00:02:31,438
is applied with increasing intensity up
to 10 seconds

40
00:02:31,438 --> 00:02:35,030
until the patient demonstrates a
response went to Mike Smith stimulus has

41
00:02:35,030 --> 00:02:38,009
been applied

42
00:02:38,009 --> 00:02:38,539
if the

43
00:02:38,539 --> 00:02:42,688
opens our eyes because to pressure

44
00:02:42,688 --> 00:02:43,439
if they do

45
00:02:43,439 --> 00:02:48,060
in their eyes recorders non if their
local factors

46
00:02:48,060 --> 00:02:51,650
such as well Inc interfering with an
eye-opening we caught

47
00:02:51,650 --> 00:02:54,080
eyes not testable

48
00:02:54,080 --> 00:02:57,689
to assess a verbal response as a patient
to tell you the name

49
00:02:57,688 --> 00:03:01,889
where they are what month it is if the
answer correctly

50
00:03:01,889 --> 00:03:05,859
record orientated his joining
conversation

51
00:03:05,860 --> 00:03:10,129
the patient is able to speak in phrases
or sentences but is unable to keep the

52
00:03:10,128 --> 00:03:12,789
crate answers to these questions about
orientation

53
00:03:12,789 --> 00:03:16,919
record confused if they do not talk
sensibly

54
00:03:16,919 --> 00:03:20,108
with two single words record words

55
00:03:20,109 --> 00:03:23,879
if the patient moans and groans with no
recognizable words

56
00:03:23,878 --> 00:03:27,479
record sounds

57
00:03:27,479 --> 00:03:27,919
if the pay

58
00:03:27,919 --> 00:03:30,958
makes no sense at all them accord none

59
00:03:30,959 --> 00:03:34,569
member speech listeners may result from
factors

60
00:03:34,568 --> 00:03:39,119
other than to press consciousness for
example the presence 7&8 kill cheap

61
00:03:39,120 --> 00:03:44,480
in these cases record they will not
testable

62
00:03:44,479 --> 00:03:44,939
to assess

63
00:03:44,939 --> 00:03:48,599
the motor component to the qAME scale
for says the patient to perform a

64
00:03:48,599 --> 00:03:49,759
two-step action

65
00:03:49,759 --> 00:03:53,840
by asking them to grasp unleash your
fingers with the hand opening the mouth

66
00:03:53,840 --> 00:03:57,099
mistake and it on if the patient does
this

67
00:03:57,099 --> 00:04:01,530
record a base commands if the person
come with their arms

68
00:04:01,530 --> 00:04:05,449
for example because a spinal injury you
should us into open m-f

69
00:04:05,449 --> 00:04:09,109
and stick at it on in a patient who it
is not be commands

70
00:04:09,110 --> 00:04:13,020
prefer stimulus alone is inadequate to
assess the motor components became a

71
00:04:13,020 --> 00:04:13,510
scale

72
00:04:13,509 --> 00:04:17,389
and an additional central stimulus is
needed

73
00:04:17,389 --> 00:04:19,680
this is for supplied by the two pieces
pinch

74
00:04:19,680 --> 00:04:23,920
to perform this place your hand if the
patient shoulder

75
00:04:23,920 --> 00:04:28,439
can pressure fingers into the muscle
above the shoulder blade apply pressure

76
00:04:28,439 --> 00:04:29,860
with increasing intensity

77
00:04:29,860 --> 00:04:33,560
for up to 10 seconds into your show that
the response you observe

78
00:04:33,560 --> 00:04:36,668
is a patient's best response

79
00:04:36,668 --> 00:04:40,288
the second location for central stimulus
is the supraorbital notch

80
00:04:40,288 --> 00:04:44,579
apply this stimulus if there has been no
localizing response to the two pieces

81
00:04:44,579 --> 00:04:45,248
pinch

82
00:04:45,249 --> 00:04:48,969
this stimulus is supplied by placing a
hand on the forehead

83
00:04:48,968 --> 00:04:53,129
with the film over the operant the
orbits feel for the notch in the Super

84
00:04:53,129 --> 00:04:54,479
ok so margin

85
00:04:54,478 --> 00:04:58,088
apply pressure with increasing intensity
for up to 10 seconds

86
00:04:58,088 --> 00:05:02,269
into Europe's if the patient's best
response the patient should not be rated

87
00:05:02,269 --> 00:05:02,918
as having

88
00:05:02,918 --> 00:05:06,318
absence of response and to the max more
stimulus has been applied

89
00:05:06,319 --> 00:05:09,468
this stimulus should not be used in
patients with facial injuries

90
00:05:09,468 --> 00:05:12,339
adjacent to see broke too much

91
00:05:12,339 --> 00:05:15,508
if the patient moves the hand above the
clavicle a collarbone

92
00:05:15,509 --> 00:05:18,770
in an attempt to move the stimulus away
record

93
00:05:18,769 --> 00:05:22,939
work lies in if they were pulling does
not reach but the clavicle

94
00:05:22,939 --> 00:05:26,978
but does flex than they are the normally
were abnormally flexing

95
00:05:26,978 --> 00:05:31,098
in clinical practice the assessment of
these non localizing sponsors

96
00:05:31,098 --> 00:05:34,810
is based on a combination of both
peripheral and central stimulus

97
00:05:34,810 --> 00:05:38,120
in normal flexion they'll be Benz

98
00:05:38,120 --> 00:05:41,569
and the army's rapidly away from the
body from the stimulus

99
00:05:41,569 --> 00:05:45,470
in abnormal flexion they ever been
slowly

100
00:05:45,470 --> 00:05:48,910
and the on comes across the body if in
doubt

101
00:05:48,910 --> 00:05:53,599
we called normal flexion if the patient
extends elbows

102
00:05:53,598 --> 00:05:57,310
rosanna flexing them record extension

103
00:05:57,310 --> 00:06:00,459
a patient who makes no responses you
quoted as known

104
00:06:00,459 --> 00:06:04,879
if they're paralyzed by other factors
such as prices by drokz

105
00:06:04,879 --> 00:06:10,120
record motor not testable on if
different responses are exhibited

106
00:06:10,120 --> 00:06:11,098
between limbs

107
00:06:11,098 --> 00:06:14,500
on right and left sides because the
better side response

108
00:06:14,500 --> 00:06:19,038
as a best indexes overall responsiveness
response to the west side

109
00:06:19,038 --> 00:06:23,300
my reflects focal brain damage a local
injury

110
00:06:23,300 --> 00:06:27,569
so to recap check for factors that might
interfere with your assessment

111
00:06:27,569 --> 00:06:30,860
who says the patient for spontaneous
eye-opening speech

112
00:06:30,860 --> 00:06:34,420
movement if necessary then stimulate the
patient

113
00:06:34,420 --> 00:06:38,140
festively and then physically

114
00:06:38,139 --> 00:06:41,099
findings should be documented clearly on
a Cayman scale chart

115
00:06:41,100 --> 00:06:45,379
the observations can then be clearly
communicated

116
00:06:45,379 --> 00:06:48,790
and the trend rapidly preciate it so the
any improvement

117
00:06:48,790 --> 00:06:52,879
or deterioration in a patient's
condition can be seen patient ratings

118
00:06:52,879 --> 00:06:54,459
can be documented numerically

119
00:06:54,459 --> 00:06:59,169
as a show Hyundai to quickly report
findings when describing the patient

120
00:06:59,170 --> 00:07:02,189
always use a four criteria alongside the
numbers

121
00:07:02,189 --> 00:07:05,500
to ensure that the assessment is
accurately understood the show had

122
00:07:05,500 --> 00:07:08,930
numbers can also be added together to
give a total coma school

123
00:07:08,930 --> 00:07:13,650
this provides an overview summary of the
severity of the patient's condition

124
00:07:13,649 --> 00:07:17,359
but this code does not communicate more
informative detailed description of each

125
00:07:17,360 --> 00:07:18,180
response

126
00:07:18,180 --> 00:07:21,680
we should always be used in addition to
the school in clinical care

127
00:07:21,680 --> 00:07:25,110
of an individual patient ok

128
00:07:25,110 --> 00:07:28,770
this approach to assessment has been
drawn together into a structured summary

129
00:07:28,769 --> 00:07:33,529
you can download from the website
Glasgow Coma Scale to walk

130
00:07:33,529 --> 00:07:37,159
hey you can also find more information
about the use of the Coma Scale

131
00:07:37,160 --> 00:07:37,720
assessment

00:07:37,720 --> 00:07:42,720
ÏÂÔØYouTube(cc)×ÖÄ»Çë·ÃÎÊhttp://zhuwei.me/youtube