Ranchos Pediatric Levels of Consciousness

Question 1

I

Answer 1

6m-2y: interacts with environment
- Active interest in toys, watches other children play, initiates social contact, shows active interest in bottle, reaches for or moves toward person or object of interest

2-5 y: oriented to self and surroundings
- provides accurate info about self, knows he/she is away from home, knows where toys/clothes are kept, actively participates in therapy, recognizes own room, is potty trained, initiates social contact

5y and older: oriented to time and place
- provided accurate and detailed information about self, knows way to and from daily activities, knows sequence of daily routine, is bowel and bladder trained

Question 2

II

Answer 2

6m-2y: demonstrates awareness of environment
- Responds to name, recognizes fam members, enjoys imitative vocal play, giggles/smile when talked to/played with, fussing is quieted by soft voice or tough

2-5 y: is responsive to environment
- follows simple commands, refuses to follow command (says no or shakes head), imitates facial expressions or gestures, response to name, recognizes fam members, enjoys imitative vocal play

5y and older: is responsive to environment
- follows simple verbal/gesture requests, initiates purposeful activity, actively participates in therapy, refuses with no or head shake, imitates gestures or facial expressions

Question 3

III

Answer 3

Localized response to sensory stimuli

• Blinks when strong light crosses field of vision
• follows moving object passed w/in visual field
• turns toward or away from loud sound
• gives localized response to painful stimuli

Question 4

IV

Answer 4

Generalized response to sensory stimuli

• Generalized startle to loud sound
• Responds to repeated auditory stimuli with increased/decreased activity
• Gives generalized reflex response to painful stimuli

Question 5

V

Answer 5

No response to stimuli

Complete absence of observable change in visual, auditory or painful stimuli

Question 6

GCS

Answer 6

GCS is used to determine severity of brain damage- looks at motor response, verbal performance, and eye opening
- Each response is ranked 1-5 , sum of scores used as indication of depth of coma and severity of injury

Score 13-15 = mild
9-12 = moderate
3-8 = severe

Time dependent tool designed to assess injury severity within first 48 hours of injury

Question 7

RCLF

Answer 7

May use Ranchos Levels of Cognitive Functional- uses behavioral observation to categorize child’s functioning level and classifies pediatric level of consciousness
12 years or older can be assessed using adult ranchos