Digis All scores under 5 are considered abnormal. Its capital is Lilongwe, which is also Malawis largest city, the second largest is Blantyre, the third comw Mzuzu, the name Malawi comes from the Maravi, an old name of the Nyanja people that inhabit the area. Email or Phone Password Forgot account? Meningitis or Cerebral Malaria What would be your differential diagnosis? The Blantyre coma scale is a modification of the Pediatric Glasgow Coma Scaledesigned to assess malarial coma in children. Meningitis, Gastroenteritis and Cerebral Malaria a.
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Parameters of the Glascow coma scale Eye Opening Spontaneous eye opening 4 : if the eyes of the patient are noticed to open spontaneously, then a score of 4 is given. What this means is that the arousal mechanism in the reticular activating system of the brain is functioning. Opening to speech 3 : if the eyes are closed, then you can speak to the person by calling the name or telling the person to open the eyes.
Do not touch the person because it is the response from the speech that is being assessed. If there is response to a normal speaking voice, then try to increase the tone.
If the patient opens eyes to speech, then a score of 3 is given. Opening eyes to pain 2 : Physical stimulation, usually in the form of pressure on the fingernail bed using a pencil or pen is applied. Another way of ensuring physical pain is stimulated is by using the knuckles of the index finger to rub on the sternum. It is important that when different medical personnel are doing this, they should all use the same method of applying physical stimulation to ensure consistent, accurate findings.
However, care must be taken not to inflict injury on the patient especially that of the sternum. No eye opening 1 : If no response is demonstrated in either eye to increased painful stimuli, there is depression of the arousal system. Sometimes, the patient may be sufficiently alert to respond by opening the eyes, but is restricted by swelling of the eyelids. If the eyelids are swollen and prevents the patient from opening, then C is recorded.
Scores of 3 and 4 in eye opening suggest that the cerebral cortex is processing information, even though this is also seen in the vegetative state. A score of 2 shows that lower levels of brain is functioning. Best verbal response The patients ability to speak and to understand the languages spoken are determined. If the patient is intubated has a tube used for breathing or has a tracheostomy a surgical opening on the neck made to aid respiration , verbal response cannot be observed and T is recorded.
Speech is first used to stimulate a verbal response by asking the patient simple, direct questions such as: is this your wife if the wife is there? Where are you? If there is no response, a light touch is used or, if necessary, painful physical stimulation. Patient responses are rated as being: Oriented 5 : if able to respond as to who he or she is, where he or she is and give the year, month and day. You may be surprised that some may not even know the name of their husband, wife or theirs.
If oriented, a score of 5 is given. Confused 4 : if not fully oriented to time, place and person, then 4 is recorded. Inappropriate 3 : if the patient utters words in a disorganized way, swears or does not engage in meaningful conversion, then 3 is given.
Incomprehensible 2 : when responses are limited to moaning, groaning or mumbling sounds with no recognizable words; give a score of 2.
No response 1 : when no sounds are made in response to noxious stimuli, a score of 1 is recorded. Best motor response The best motor response of the Glascow coma scale in either arm is usually observed by asking the patient to raise the arms forwards for about 10 seconds. The ratings in order of decreasing levels of function include: Obeys command 6 : when the patient understands verbal, written instructions or gestures and performs the requested movement, give a score of 6.
Localization to pain 5 : this occurs when there is no response to command. A painful stimulus is then applied such as pressure on the patients fingernail bed or stimulation to an area of the head or trunk or rubbing of the knuckle of the index finger on the sternum.
The patient moves a limb in an attempt to locate and remove the stimulus. In this, give a GCS score of 5. Flexion withdrawal to pain 4 : occurs when the arm bends at the elbow in response to fingernail bed pressure or other local stimulation. Leg flexion is not a reliable gauge because with brain death, a spinal reflex may be present, causing the legs to flex in response to localized pain. Abnormal flexion - Decorticate 3 : This occurs when a painful stimulus is applied and the arms flexes at the elbow and pronates, making a fist.
If the patients arms move toward their chest, their fingers and wrists flex on their chest and they point their toes, then they are said to have decorticate posturing and a score of 3 is recorded. Decorticate posture shows there is head injury and some patients may present with this posture even before initiation of the painful stimuli. Abnormal extension to pain Decerebrate posture 2 : occurs when the elbow straightens and the arm abducts usually with internal rotation in response to localized pain applied to the fingernail bed.
If one arm and the other extends, the best response is recorded. If the patients arms and legs extend, their wrists rotate away from their body and they point their toes, then they are said to have decerebrate posturing and receive a score of 2. Decerebrate posture shows the presence of head injury too. No response 1 : is recorded when no detectable movement or change in the tone of the limbs is observed in response to repeated and varied stimuli.
A score of 3 in motor responses indicates that the lesion is originating in the internal capsule or the cerebral hemispheres and is caused by disinhibition through the removal of corticospinal pathways above the midbrain. Also, a motor response score of 2 describes a midbrain to upper pontine damage and is attributed to the disinhibition of vestibulospinal tract and pontine reticular formation by removing inhibition of medullary reticular formation transection at intercollicular level between vestibular and red nuclei.
GCS Score, Glascow Coma Scale and Blantyre Score Assesment and Interpretation
Samuktilar The score assigned by the Blantyre coma scale is a number from 0 to 5. Scottish inventions Revolvy Brain revolvybrain. The score is determined by adding the results from three groups: All scores under 5 are considered abnormal. In hospitals it is also used in monitoring chronic patients in intensive care. Intensive care medicine Revolvy Brain revolvybrain.
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