GCS ppt

GCS PPT

1. GCS ppt Prepared by: Prof.VIJAYREDDY VANDALI PhD Scholar, M.Sc (N), PGDHA,PGCDE. Dept of MSN. INDIA .

2. Glasgow Coma Scale The Glasgow Coma Scale (GCS) is used to describe the general level of consciousness in patients with  traumatic brain injury  (TBI) and to define broad categories of head injury.  [1]  The GCS is divided into 3 categories, eye opening (E), motor response (M), and verbal response (V). The score is determined by the sum of the score in each of the 3 categories, with a maximum score of 15 and a minimum score of 3 .

3. The three responses measured are: Best motor response - maximum score of 6 Best verbal response - maximum score of 5 Eye opening - maximum score of 4.

4. The lowest score for each category is 1, therefore the lowest score is 3 (no response to pain + no verbalization + no eye opening ). A GCS of 8 or less indicates severe injury, one of 9-12 moderate injury, and a GCS score of 13-15 is obtained when the injury is minor.

5. Grades of Best Motor Response   6 Carrying out request ('obeying command') -patient does simple things you ask.  5 Localising response to pain.  4 Withdrawal to pain - pulls limb away from painful stimulus.  3 Flexor response to pain - pressure on nail bed causes abnormal flexion of limbs - decorticate posture.  2 Extensor posturing to pain - stimulus causes limb extension - decerebrate posture.  1 No response to pain.

6. Grades of Best Verbal Response   5 Oriented - patient knows who and where they are, and why, and the year, season and month.  4 Confused conversation - patient responds in conversational manner, with some disorientation and confusion.  3 Inappropriate speech - random or exclamatory speech, with no conversational exchange.  2 Incomprehensible speech - no words uttered, only moaning.  1 No verbal response.

7. Eye Opening   4 Spontaneous eye opening.  3 Eye opening in response to speech - that is, any speech or shout.  2 Eye opening in response to pain.  1 No eye opening. 

8. CASE HISTORY - CASE 1 Presentation A 64 year old woman with hypertension was admitted by her GP after complaining of right-sided weakness. Over the next couple of days her condition worsened, and four days later she appeared to suffer a serious stroke, following which she was completely unresponsive. Tests confirmed brain stem death and permission was sought to switch off her life support. History The woman had a 10-year history of hypertension. When she noticed loss of sensation and loss of power on her right side she went to her GP, who had her admitted. Examination Pulse was 80bpm, bp 154/80, normal heart sounds. A positive Babinsky sign was noted in her right foot. Moderate loss of power and sensation of limbs on right side. Weakness of right side of face, and dysarthria . Test results: No abnormal findings on CT scan or EEG. Progression She showed no improvement of her right-sided weakness after admission to hospital. A small stroke was suspected, but no lesion could be seen on the CT scan. Four days after admission she deteriorated. Her  Glasgow coma scale  rating was 3. She was totally unresponsive. An MRI showed a suspected brain stem haemorrhage and a small established infarct in the left parietal lobe. When tests showed brain stem death, permission was sought from her family to switch off her life support, and she died 6 days after admission.

9. REFERENCES 1.https :// www.le.ac.uk /pa/teach/ va /case_1/ gcs.html 2. https:// emedicine.medscap e.com 3.Wikipedia

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