Reduced GCS Flashcards
causes of coma
seizure infection CVA low CO hypoxia hypercapnia CO poisoning uraemica hepatic encephalopathy hypoglyc hypo/hypernat hypothyroid hypothermia opiates benzos tricyclics alcohol
when to do GCS
in abcDe
who is AVPU used for
children
what does AVPU stand for
alert (opens eyes spontaneously)
voice (opens eyes to voice)#
responds to pain
unresponsive
GCS three parts
eyes, verbal, motor
eyes score
4 opens spontaneously
3 opens to speech
2 to pressure
1 none
verbal score
5 orientated 4 confused 3 inappropriate words 2 incomprehnsible sounds 1 none
motor score
6 obeys commands 5 localises pain 4 normal flexion to pain 3 abnormal flexion to pain 2 extension to pain 1 none
what score in trauma indicates need for ET intubation
<8. if it’s 8 or more they will probably vomit and aspirate SO DON’T DO THIS!!!!!
how often do you do neuro obs for someone with reduced GCS
AT LEAST every half hr
for any trauma, spinal precautions until
C-spine cleared by radiologist/clinician
GCS of someone with epidural haemorrhage is falling. what is likely cause
epidural haemorrhage is expanding. this is an emergency and EDH needs evacuating immediately by neurosurgeon
if someone’s airway falls to below 9, what do you need to do and why
intubate. airway no longer protected so risks aspiration (especially if full stomach incl. been drinking lots)
indications for intubation
failure to maintain airway absent gag GCS <9 AVPU - P poor ventilation (hypoxia, hypercarbia) impending brain herniation
someone with extradural haemorrhage has mydriasis (pupil dilatation). why?
critically elevated ICP compressing occulomotor nerve. unless decompressed will cone (herniation of the brain through the foramen magnum - nearly always die)
