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.
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.
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.
The Glasgow Coma Scale is an
assessment based on numeric scoring of the patient’s responses.
1. No response
2. To pain
3. To speech
4. Spontaneously
1. No response
2. Extension – abnormal
3. Flexion – abnormal
4. Flexion – with drawl
5. Localizes pain
6. Obeys verbal commands
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.
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