2: Memory, Coma, Motor Regions Flashcards
Glasgow Coma Scale
most common neurological scoring system used to describe level of consciousness following a traumatic brain injury
GCS contraindication
not used w children (esp young ones who don’t have reliable language skills)
3 behaviours assessed by GCS
eye opening
best verbal response
best motor response
ways to interpret the total score of the GCS
15 = best response
8 or less = Comatose client (in a state of coma)
3 = totally unresponsive
how is the GCS expressed
indicating the total sum of the score but also the individual elements:
“GCS 9 = E2 V4 M3 at 07:35”
general classification of brain injury
Severe, GCS <8-9
Moderate, GCS 8 - 12
Minor, GCS >/= 13
4 main Vital Signs monitored + 2 additional signs monitored
- blood pressure
- pulse rate
- respiratory rate
- temperature
* oxygen saturation
* *pupillary size
average normal values for the 4 vital signs
- blood pressure: less than 120/80 mmHg
- pulse rate: 60-100 bpm
- resp rate: 12-16 breaths/min
- temp: 36.5 - 37.2 degrees Celsius
high blood pressure?
140/90 mmHg or greater
high body temp (fever)?
1 degree above normal range. can also have hyPOthermia
two monitoring tests for the brain
EEG
Neuroimaging
EEG? function?
ElectroEncephaloGraphy: detects electrical activity of brain (only 0.1% - 1%) still, useful for investig neuro disorders
Neuroimaging options
- X-rays: plain/computed tomography (CT) etc
- Magnetic Resonance (MRI/MRA [Mag. Res. Angiography])
- Radioisotopes: PET scan (Positron Emission Tomography)/ SPECT (Single photon emmission computed tomography)
sequence for assessing a comatose patient
- Glasgow Coma Scale
- Vital signs
- X-rays
Causes for coma (x3)
- Diffuse brain dysfunction
- metabolic/toxic disorders depressing brain function (drug overdose, chronic hypoxia, epilepsy) - Direct effect
- within brainstem
- a lesion may inhibit reticular formation - Pressure effect
- mass lesion within the brain that compresses the brainstem thus inhibiting retic. formation