Level of Consciousness

Level of Consciousness

Loss of consciousness means that there is some interference with the normal working of the brain. The person who is unconscious is not aware of what is happening around him.

Level of Consciousness

The level of consciousness is determined by the activity of the brain. It can be categorized as follows:

1.        Alert (a):- Sound and clear mind responding normally an answering questions swiftly.

2.        Response to voice (v):- feels tired and sleepy. Wakes up easily and able to do as told or answers simple questions. The patient is in a state of confusion nevertheless and is easily agitated.

3.        Response to pain (p):- Difficult to wake up but will respond to pain. The patient cannot answer questions properly.

4.        Unresponsive (u):- Impossible to be woken up with no response to external stimulation.

NOTE:

Anything below alert is unconscious. From there we need to determine how unconscious the patient is. A patient can be unconscious with response to stimuli or unresponsive.

Glasgow Coma Scale

The Glasgow Coma Scale is an assessment based on numeric scoring of the patient’s responses.

Glascow Coma Scale

Best Eye opening Response

1. No response

2. To pain

3. To speech

4. Spontaneously

Motor Response

1. No response

2. Extension – abnormal

3. Flexion – abnormal

4. Flexion – with drawl

5. Localizes pain

6. Obeys verbal commands

Best Verbal Response

1. No response

2. Sounds – incomprehensible

3. Speech – inappropriate

4. Conversation – confused

5. Oriented

1.        Eye opening : ( 1-4 points)

a)       Spontaneous: 4. Eyes are opened and focused. The patient can recognise you and follow eye movements.

Lower the score is 3 – coma Less then – 8 – severe injury 9-12 - moderate injury

13- 14 - minor injury

b)       To voice (E 3):

The patient opens his eyes when spoken to or when directed to do so. c) To pain: (E2):

The patient opens his eyes when given some sort of painful stimuli.

c)        To pain: (E2)

d)       None (E1)

2.        Motor Response (1-6 points)

a)       Obeys commands( M 6)

b)       Localize pain (M5)

c)        Withdraws to pain (M4)

d)       Flexion (M3)

e)        Extension (M2)

f)         None (M1)

3.        Verbal Response (1-5 POINTS)

a)       Oriented (v5);

The patient can talk and answer questions about his location, time, and who he is. This scale is used to measure the level of consciousness traumatically injured persons and all chronically ill patients.