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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.

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Emergency and Urgent Care for Children: a Survival Guide

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FutureLearn - Learning For Life

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