The Resus Room GCS; Roadside to Resus
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May 15, 2025 Explore the Glasgow Coma Scale and its pivotal role in assessing consciousness for over 50 years. Delve into its origins, effectiveness, and the implications of inconsistent scoring across clinicians. Discover how the individual components of the scale might not carry equal prognostic weight. The discussion challenges traditional assessment methods while emphasizing the need for clarity and context. With real-world applications in patient care, the conversation questions whether the GCS still meets today's medical needs.
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Origins and Purpose of GCS
- The Glasgow Coma Scale (GCS) was designed over 50 years ago to assess impaired consciousness and track progress, mainly in brain injury patients.
- It has evolved beyond its original purpose but remains a universal communication tool in medical care.
Proper Eye Response Assessment
- To assess the eyes component, give the patient a moment to wake up before testing eye opening.
- Assess eye opening contextually: spontaneous, to sound, to pain, or none, not just physical openness.
Consistent Verbal Response Scoring
- Use consistent questions to assess verbal response, like orientation to person, place, and time.
- Document 'not testable' for patients who cannot speak, e.g., intubated or tracheostomized, instead of scoring one.