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Coma
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GCS GCS is a best score. The bottom score is 3/15.
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Eyes Eye scores are not particularly helpful
Pupil assessment is very helpful.
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Voice Is also less helpful It is quite subjective
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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.
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Situation one You have been asked to review a 4 year old boy who had a one hour anaesthetic and is slow to wake.
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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.
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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.
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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
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