Glasgow Coma Scale

Evaluation of the physiologic effects of high-flow nasal cannula (HFNC), which “is a heated, humidified, high-flow oxygen delivery system that can generate total gas flows of up to 60 L/min with an adjustable FIO2”, compared to conventional oxygen therapy (COT) for patients with hypoxemia and acute dyspnea in the emergency department was the focus of this study published in the American Association for Respiratory Care Journal (Rittayami, Tscheikuna, Praphruetkit, & Kijpinyochai, 2015). The…

This scale was a modification of less commonly used 3 and 14 and is best known as the Modified GCS. Michael scored 15/15. GCS ≥13 is classified as minor brain injury which seemed applicable for Michael. The GCS has come under controversy amongst researchers regarding its poor inter-rater reliability and lack of prognostic-utility.(14) Newer scores such as simplified motor-scale and FOUR Score have been developed as improvements to the GCS.(15)…

An unconscious patient poses many ethical and legal difficulties. As medical students we must use principles from all three 'Tomorrow's Doctor' outcomes to allow us to appropriately care for a patient who is unable to respond to questioning or consent to treatment. There are three outcomes we must pertain too: a doctor as a scientist and scholar, a doctor as a practitioner and a doctor as a professional. Immediately when presented with an unconscious patient the first duty of care is to ensure…

Introduction Approximately 1.7 million people acquire a traumatic brain injury in the United States every year, impacting millions of people’s daily lives (Powell, Rich, & Wise, 2016). A traumatic brain injury (TBI) occurs when an external or internal force impacts the brain, which causes physical and chemical alterations in the brain. In recent years, rates of TBI have increased dramatically; however, more people are receiving treatment after a TBI, so mortality rates are decreasing (“Rates of…

Cervical spine injuries are caused by a number of things. This includes gunshot wounds, car accidents, diving accidents, landing on the head because of a sports injury, falls from a great height, electric shock and other traumatic injuries (Dahlquist, Fischer, Desai, Rogers, Christmas, Gibbs, & Sing, 2015). There have not been any recent studies on how common spinal injuries are, but according to the National Spinal Cord Injury Statistical Center (2012), there are approximately 12,000 new cases…

to touch. Gait is normal. Her speech was slurred. Had slight trouble swallowing. Signs and symptoms: Loss of consciousness, Drowsy, Shortness of breathing, Dysphasia, Ocular signs, decreased motor function, Headache, vomiting. Assessment: Glasgow coma scale, Assessing for changes in LOC, pupil reaction and size, motor function, sensory function and vital signs and pain score, Family history, medical history. Clinical reasoning Aitken (2003) states that when adequate thought and clinical…

While working in the emergency department at Aga Khan Hospital for six years I became familiar with many different forms of technology used in the health care environment. We used the electronic medical record (EMR), picture archiving and communication system (PACS) – a health care technology used for short and long term storage, management and distribution of medical images, lab tests, MRI tests, and CT scans. On my unit we also used portable x-ray and ultrasound machines, arterial blood gas…

Subdural haematoma (SDH) is a type of focal brain injury which consists of contusions and bleeding (Sawauchi & Abe, 2008). Contusions and bleeding occur from small tears in blood vessels which are commonly caused by external forces such as vehicular accidents and falls (Craft et al., 2015). Subdural haematoma can be described as an extra cerebral blood collection which is located between the dura mater and the middle layer of the meninges (Iliescu, 2015). The development of haematoma does not…

Part B – Preparation for interview and application 1. Demonstrated high level interpersonal, verbal and written communication skills. My interpersonal and communication skills were developed through successfully interacting with patients, families and other staff members during placements. Oftentimes, handing over patients to other nurses or other healthcare professionals had to be completed for optimal care. I was able to develop my verbal communication skills by using ISBAR when handing…

Often, the result of the trauma leads to permanent damage of the brain resulting in neurological damage that is chronic. A Glasgow Coma Scale is used to determine the extent of the injury. It is scored based on mild, moderate, and severe with a numeric score of three to fifteen. It rates the eyes, verbal response, and motor response. There is also a modified pediatric version for…