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dmshaw9
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Levels of Consciousness Exam
- Determine orientation to person, place, and time (A & O x 3)
- Determine response to stimuli
- Determine level of consciousness (arousal)
- Glasgow Coma Scale (GCS)
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Determine Response to Stimuli
- Purposeful, non-purposeful, no response
- Verbal, tactile, simple commands
- Painful stimuli (pinch, pinprick)
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Alertness
- Alert pt responds appropriately
- Can open eyes, look at examiner, respond fully and appropriately to stimuli
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Lethargy
- Pt appears drowsy
- Can open eyes and look at examiner, responds to questions, but falls asleep easily
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Obtundation
- Pt can open eyes and look at examiner
- Responds slowly and is confused
- Demonstrates decreased alertness and interest in environment
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Stupor
- Pt can be aroused from sleep only with painful stimuli
- Verbal responses are slow or absent
- Pt returns to unresponsive state when stimuli are removed
- Demonstrates minimal awareness of self and environment
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Coma
- A state of unconsciousness from which pt cannot be aroused
- Eyes remain closed
- No response to external stimuli or environment
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Unresponsive Vigilance (Vegetative) State
- State characterized by:
- Return of sleep/wake cycles
- Normalization of vegetative functions (respiration, HR, BP, digestion)
- Lack of cognitive responsiveness (can be aroused but is unaware
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Persistent Vegetative State
A state lasting > 1 year for TBI and > 3 months for anoxic brain injury
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Minimally Conscious State (MCS)
State characterized by severely altered consciousness with minimal but definite evidence of self or environmental awareness
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Glasgow Coma Scale
- Relates consciousness to 3 elements of response: eye opening, motor response, and verbal response
- Scoring ranges from 3-15
- Severe brain injury: 1-8
- Moderate brain injury: 9-12
- Minor brain injury: 13-15
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