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Glassgow
This document discusses the Glasgow Coma Scale (GCS), which is used to assess head injuries. It provides background on head injuries and their causes before explaining the components of the GCS. The GCS assesses eye opening, verbal response, and motor response on a scale of 1-6 to determine a patient's level of consciousness following a head injury. Scores are categorized as mild, moderate, or severe injury. Though widely used to predict outcomes, the GCS does not account for all factors like focal signs or intoxication.
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- 1. GLASGOW COMA SCALE Dr.Faisal KA Tutor Malabar Dental College and Research Centre
- 2. introduction Head injuriesare one of the common causes of death in road traffic accidents It can be open or closed injuries depending on whether there is fracture skull with meningeal injuries causing CSF leak or not . CSF can leak through scalp wound/ear/nose based on site of injury After initial steps for preservation of life are taken satisfactorily and patient has been stabilized ,then a full examination of patient is carried out to detect the presence of associated important injuries
- 3. Triage Means ‘tosort out’ in French It was a system to attend patients with trauma Assessing 4 component i. Physiologic assessment ii. Anatomical injury iii. Biomechanical injury iv. Comorbid factors
- 4. Clinical approach ofa patient with head injury Detail history of injury-process of deterioration-rapid or gradual History of alcohol intake Neurological assessment: by a. Level of consciousness- Glasgow coma scale b. Pupillary reaction to light and size c. Pulse d. Temperature e. Blood pressure f. Respiratory rate g. Reflexes h. Limb movements- normal/mild weakness/severe weakness/spastic flexion/extension/no response Status and protection of airway General assessment for other injuries
- 5. Glasgow coma scale This scale relates clinical observations for motor response, verbal response, and eye examination and its response Level of consciousness should be assessed: Fully conscious Drowsy patient with disorientation , but responds irrationally to spoken questions Semiconscious patient Semi coma(unconscious but responds to painful stimuli) coma
- 6. history Developed in1974 by Teasdale and Jennet First attempt to quantify the severity of head injury Include 3 variables 1. Best motor response(reflects level of CNS function) 2. Best verbal response(CNS ability to integrate information) 3. Eye opening (function of brain stem activity)
- 8. Glasgow coma scale Eye opening 4-opens eyes spontaneously 3-opens eyes to voice 2-opens eyes to pain 1-no eye opening C-unable to open eyes due to any swellings
- 9. Glasgow coma scale Motor response 6-obeys commands 5-localises to pain 4-withdraws to pain 3-abnormal flexor response 2-abnormal extensor response 1-no movement
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- 11. Glasgow coma scale Verbal response 5-oriented 4-confused 3-inappropriate words 2-incomprehensible sounds 1-no sounds D-unable to speak coherently T- tracheostomy
- 12. inference Total score-15 Mild head injury:- 13-15 Moderate head injury :-9-12 Severe head injury :- less than 8(3-8) In a prospective multicenter study GCS of 9 or less-higher mortality rates Used to predict outcomes
- 13. Weaknesses of GCS Doesnot take in to account focal or lateralizing sign Diffuse metabolic processes intoxication
- 14. References SRB’ smanual of surgery Peterson’s principles of oral and maxillofacial surgery Textbook of oral and maxillofacial surgery- S M balaji
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