Clearly explains exactly how to perform this examination without using complex terminology; exceptionally clean cinematography is exceptionally helpful. This video seems accepting of the chance some may be distressed while trying to view and understand the GCS. Thank you.
The video is great but I just noticed something that needs to be corrected. Applying pressure at the tip of the nail as a peripheral pain stimulus won't work. Pressure should be applied on the nailbed instead.
I had the pleasure of working for the Royal College Of Physicians And Surgeons of Glasgow and Sir Graham was our president at the time. I also had the pleasure of working with Sir Graham on the Wedding of one of his sons in the College Hall which turned out to be a very successful day and night and Sir Graham couldn't thank me enough. He was our President for 3 years and his successor was Dr Brian Willams who was another very nice President to work for
Great video! A more realistic example of decerebrate and decorticate posturing would be helpful. In my experience it looks much more abnormal than this...more like a slow reflex action and not as brisk. Thanks for putting this together.
Perfect and effective way to learn ...tracheostomy seems mistaken for ET tube... * supraorbital notch stimulation I read that it might encourage grimace and may not get pt to open eyes..
It is a tracheostomy. And supraorbital notch stimulation is for the motor response portion of the GCS. For the eyes, it is suggested you apply pressure to a nail.
I don't know if this is relevant or will be helpful??? I was in a coma almost 2 years ago, I did rather well with the verbal response questions before my release from the hospital. But I only knew the right answers because I'd heard others talking about them, but the fact I remembered was still great. I have the attention span of a gnat now, and a speech impediment. If I might make a suggestion, the worst part, even above the pain, was waking up surrounded by people that assumed I knew what was going on (who I was, what I was, where I was), maybe let a person know there human, and they have a name, and what it is???
So what if a patient has a Verbal score of say, 4... what if they are perfectly alert but are too confused to follow the commands for the motor skills assessment -- seems strange that if they can't follow a 2-part movement request that we would just escalate the situation to a trap squeeze. Imagine hurting a patient with dementia, just because they couldn't perform a 2-part movement request.
Demo is good but the narration is very bad. @4:50 couldn't understand the term what he said. English is not hard but it's hard when the person speaking doesn't speak clearly.
When called by using name, if the patient does not open his eyes, does not respond by sound and does not respond by any bodily movement can it be taken as least score in the GCS indicating coma?
Wonderful to have Graham Teasdale introduce this clip. An excellent explanation (of course) but I would love to have additional explanation provided in terms of noting when a patient responds to Shout & SHAKE, as opposed to requiring 'pressure' stimulus; and to have the use of assessing limb strength explained in addition to best motor response. I find it can get messy with critically ill patients who may exhibit normal flexion response and then limb strength is assessed without a purposeful movement.
It's awesome 👏🏻 the best method of education But please can anyone write it just like an essay to understand it more ,because i can't speake English fluently !!! So it will be more easy to read it rather than hearing it
Sternal rub is not a good way to assess response. After repeated assessments over days, the skin can break down and provides a portal for infection. I have seen this many times in my 30years + in ICU. The bruising and injuries caused by sternal rubs are in my opinion unacceptable and unnecessary. It constitutes assault. If I woke up in hospital with a chest injury caused by repeated sternal rubs, I would sue.
