Essay Example on GLASGOW COMA SCALE It was published in the year of 1974








GLASGOW COMA SCALE It was published in the year of 1974 by Graham Teasdale and Bryan Jennett professor of neurosurgery at the university of Glasgow institute of neurological science at the city's southern general hospital METHODS USED FOR It was initially used to assess the level of consciousness after head injury traumatic accident It is most important assessment method in the department of emergency medicine It is used in the medicine department for the stroke patients to assess their level of consciousness its is most widely used nowadays It is also used for diagnosing and treating patient with physiotherapy exercises for the particular arms LIMITATIONS It can't asses the brain stem reflexes Application of the Glasgow Coma Scale to intubated patients The prognostic value of the components of the Glasgow Coma Scale following acute stroke The stroke is the life threatening medical condition that occurs when the brain couldn't receive the blood and it's the most common problem in the old age people and it also manifest as the medical emergency for diagnosing and treating the patient with stroke Glasgow coma scale plays an important role The patient are selected in the presence or absence of coma stage as stroke may cause localized motor speech or language deficits the accuracy of measuring conscious level can be missed so sometimes the prognostic value of it can be impaired Conversely in patients with a language disorder the verbal score may reflect stroke severity in addition to its measurement of consciousness level and for that reason it may retain useful prognostic information

The total GCS score predicted acute mortality with 88 accuracy and the verbal component could be excluded from the total GCS score without loss of predictive value Comparison of Glasgow scale and Apache II Score for Stroke Patients APACHE II is Acute Physiology And Chronic Health Evaluation II it is a severity of disease classification system its like one of the several ICU intensive care unit scoring system It is applied within 24 hours of admission of a patient to the ICU and in this the integer score is from 0 to 71 The score is computed based on several measurements as the score increase the severity of the disease increase and the patient will be have higher incidence death The first APACHE model was presented by Knaus in 1981 Measurement of severity of illness has become a vital component of health care research over the past decade1 3 for its potential value in assessing quality of care For real time use accurate prognostic assessment may assist clinical management and counseling of patients and their families the study performed by HCFA and the Health Data Institute a severity of illness measure based on the APACHE II systemHowever the Glasgow Coma Scale because of its relative simplicity of measurement and abstraction may be preferable to the APACHE II system as a severity of illness measure if the former demonstrates comparable accuracy So the study compared the accuracy of the APACHE II system with that of the Glasgow Coma Scale for patients hospitalized with stroke The study was performed at Cedars Sinai Medical Center an 1 100 bed community teaching hospital serving west Los Angeles

 The Glasgow Coma Scale has fared well in predicting outcome for patients with intracerebral hemorrhage although its accuracy in predicting outcome for patients with nonhemorrhagic stroke is uncertain We suggest that the Glasgow Coma Scale is a useful severity of illness measure for stroke patients including those without intracerebral hemorrhage 93 of our study patients and may be used instead of the APACHE II system for that purpose In fact the APACHE II score added no additional predictive information to that provided by the Glasgow Coma Scale score Initial Glasgow Coma Scale Score also Predicts Outcome Following Thrombolysis for Posterior Circulation Stroke Thrombolytic therapy for posterior circulation stroke may be beneficial when initiated after 8 hours of symptom onset Level of consciousness as measured by Glasgow Coma Scale score seems to be a more important predictor of outcome than the initial Nine patients received intravenous therapy 12 patients received intra arterial therapy

The median Glasgow Coma Scale score was 9 range 3 15 Twelve patients were treated within 8 hours of symptom onset The initial Glasgow Coma Scale score and treatment within 8 hours of symptom onset were each associated with good outcome Mortality prediction in critical care for acute stroke Severity of illness score or coma scale Stroke is the second most common cause of death in the world and the most frequent cause of permanent disability As intensive care treatment is relatively expensive and outcome of survivors is still poor the benefit of such therapy is not obvious For measuring neurological disturbances SAPS and APACHE Scores use the Glasgow Coma Scale GCS The GCS was initially developed to grade patients suffering from acute traumatic brain injury but later its use was extended to evaluate cerebral dysfunction in many fields of critical care or emergency medicine There have been few data reports about the use of those scores in acute stroke for determining survival The GCS Score was shown as an independent predictor of mortality for acute stroke patients in several studies and it seems to be equal in this regard to APACHE II Scores 24 MEASUREMENT OF GLASGOW COMA SCALE BEHAVIOUR RESPONCE SCORE EYE OPENING SPONTANEOUS TO SPEECH TO PAIN NO RESPONCE 4 3 2 1 VERBAL RESPONCE ORIENTED TO TIME PLACE PERSON CONFUSED INAPPROPRIATE WORDS INCOMPREHENSIVE SOUNDS NO RESPONCES 5 4 3 2 1 MOTOR RESPONCE OBEYS COMMAND MOVES TO LOCALIZED PAIN FLEXTION FROM WITHDRAWAL FROM PAIN ABNORMAL FLEXTION DECORTICATE ABNORMAL EXTENSION DECEREBRATE NO RESPONCE 6 5 4 3 2 1 TOTAL SCORE BEST RESPONSE COMATOSE CLIENT TOTALLY UNRESPONSIVE 15 8 0R LESS 3

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