Question

Describe ranson/imrie criteria and modified Glasgow criteria.

Answer 1

Ransons criteria

It is used to assess the morbidity and mortality associated with acute pancreatitis.

• Age->55years
• WBC Count->16000
• Serum Glucose level->200
• Serum LDH level >350
• Serum AST level>250
• During the first 48 hours=HCT decrease 10%,blood urea nitrogen increase >5mg/dl
• Serum calcium-<8mg/dl
• Base deficit >4mEq/L
• Estimated fluid sequesteration >6L
• Partial pressure of arterial oxygen <60mm Hg
• Mortality rate less than 4 signs = 1%
• Mortality rate for 3-4 signs=15%
• mortality rate for 5-6 signs=40%
• Mortality rate for 7 or more signs=100%.

Modified Glasgow Coma Scale

it is used to assess the level of consciousness in humans with traumatic brain injury and coma at initial and subsequent evaluations.

Eyes open

Appropriate stimulus

• Approach to bedside
• Verbal command
• Pain

Response

• Spontaneous response 4
• Opening of eyes to name3
• Lck of opening of eyes to previous stimuli but opening to pain2
• Lack of opening of eyes to any stimulus.1
• Untestable U

Best Verbal response

Appropriate stimulus

• Verbal questioning with maximum arousal.

Response

• Appropriate orientation,conversant,correct identification of self .5
• Confusion,conversant,but disorientation in one or more spaaces. 4
• Inappropriate use of words ,lack of sustained conversation. 3
• Incomprehensible words,sounds 2
• Lack of sound even with painful stimuli. 1
• Untestble U

Best Motor response

Appropriate stimulus

• Verbal command
• Pain.

Response

• Obedience of command .6
• Localization of pain ,lack of obedience but presence of attempts to remove offending stimulus 5.  
• Flexion withdrawl 4.
• Abnormal flexion 3
• Abnormal extension 2
• Lack of response 1
• Untestable. U