Initial assessment of the injured child
In this clip we see the paramedics doing an initial assessment of the injured child, Toby. An important part of this assessment in head injuries is the Glasgow Coma Scale.
Conscious level in children and adults can be assessed using the Glasgow Coma Scale; this is a scale which divides responsiveness into 3 separate domains: eyes, voice and motor functioning. These are each given a score and the maximum possible total is 15. Eyes score between 1 and 4. Voice scores between 1 and 5, and motor functions score between 1 and 6. The lowest possible score is 3 which would mean no response to any kind of stimulus in either eyes, voice or motor functions. A GCS of 15 suggests that somebody is alert with their eyes open, talking to you and moving normally.
Glasgow Coma Scale
Best Eye Opening
| Adult | Score | Paediatric |
|---|---|---|
| Spontaneously | 4 | Spontaneously |
| To verbal stimuli | 3 | To verbal stimuli |
| To painful stimuli | 2 | To painful stimuli |
| No eye opening | 1 | No eye opening |
Best Verbal Response
| Adult | Score | Paediatric |
|---|---|---|
| Oriented | 5 | Smiles, oriented to sounds, follows objects, interacts |
| Confused | 4 | Cries but consolable, inappropriate interactions |
| Inappropriate words | 3 | Inconsistently inconsolable, moaning |
| Incomprehensible | 2 | Inconsolable, agitated |
| No verbal response | 1 | No verbal response |
Best Motor Response
| Adult | Score | Paediatric |
|---|---|---|
| Obeys commands | 6 | Normal spontaneous |
| Localised pain | 5 | Withdraws to touch |
| Withdraws to pain | 4 | Withdraws to pain |
| Flexible to pain | 3 | Flexion to pain |
| Extension to pain | 2 | Extension to pain |
| No motor response | 1 | No motor response |
Using the GCS scoring method, calculate Glasgow Coma Scale for Toby based on what you’ve seen so far. Use the comments below to discuss your answer.
Emergency and Urgent Care for Children: a Survival Guide
Emergency and Urgent Care for Children: a Survival Guide
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