Coma.

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Presentation transcript:

Coma

GCS GCS is a best score. The bottom score is 3/15.

Eyes Eye scores are not particularly helpful Pupil assessment is very helpful.

Voice Is also less helpful It is quite subjective

Motor This is the useful score for ICU It has prognostic significance in head injury and cardiac arrest The difference between M4 and M3 is crucial.

Situation one You have been asked to review a 4 year old boy who had a one hour anaesthetic and is slow to wake.

Situation 2 You have been asked to review a 89 year old man who had a stroke three days ago and is now not responding to voice from the nurses.

Situation 3 You have been asked to review a 19 year old who had a seizure witnessed in the ward. He has just had another seizure and is unconscious.

Situation four A 43 year old trauma patient fell in the shower and banged his head. He had a fractured pelvis in an MVA 5 days ago being conservatively managed He is now not responding to voice