Question

Ken, a 46 ylo male who works as a carpenter, was admitted to the ED after having a grand ma seizure while at a construction site. At this time, Ken is unconscious but breathing on his own and no farther seizure activity is noted. His co-worker stated that Ken fell off a ladder a year and a half ago and he suffered a severe coneussion, however, he has had no further complications since recovering from that injury. An emergency computerized axial tomography (CAT) scan reveals an area of scar tissue overgrowth in the frontal lobe. He is transferred to the ICU for further observation After he is stabilized, you perform a Glascow Coma Scale assessment; findings are as follows . Best eye-opening response: No Response () Best motor response: Flexion-Withdrawal (4) Best verbal response: Sounds Incomprehensible (2) . 1. What does his Glascow Come Scale score indicate? The next morning. Ken begins to wake up. How would you assess his level of consciousness? 2. When you walk into the room he has his eyes closed but opens them when you touch his arm lightly and say his name. He appears drowsy. You ask orientation questions and he responds: Person: Able to state his name and that he is a carpenter Place: Does not know where he is but knows he is in a hospital somewhere in town and names the town correctly Time: He states it is Monday morning (it is Tuesday morning) but is able to correctly identify the month and year . . . He is able to follow verbal commands appropriately - raises his hand when asked to do so and turns his head right to left as requested. 3. What Glascow Coma Scale score would you give him now? How are you grading it? Later that afternoon Ken is more alert and anxious about his condition. While completing his admission history, you ask him if he had had any seizures before this one. He looks down and reluctantly says "Yes" and tells you that he had another seizure a week ago but was afraid to mention it at work
1-3 please

Answer 1

1. GCS or glasgow coma scale is an assessment tool used to assess the level of consciousness and neurological status of the patient usually after brain injury.

A GCS score can be interpretated as follows :

- GCS < 8-9 severe brain injury

- GCS between 9-12 moderate brain injury

- GCS above 12 mild brain injury.

In the above case the GCS score is 7 so we can say that the patient has suffered severe brain impairment.

2. The GCS assessment of the patient the next morning is as follows:

# eye opening response

To speech : 3

# best verbal response

Confused : 4

# best motor response

Obeys command : 6

The total GCS score the patient is 13

Tge patient GCS score have improved significantly from tge day of admission.

GCS score of 13 indicates minor brain impairment and good prognosis.

3. The patient has recovered considerably. He is opening his eyes spontaneously, is oriented to time, place and person and obeys motor command.

GCS score is graded as follows:

# best eye response

Spontaneous 4

# best motor response

Obeys command 6

# best verbal response

Oriented to time, place and person 5

The total GCS score is 15.