Richting relatie tussen constraints en waardelijsten is fout
Concept
Fifteen-point scale for expressing a person’s level of consciousness, from fully awake to deep unconsciousness, in a number: the so-called EMV score.
The Glasgow Coma Scale score or EMV (Eye-Motor-Verbal) score is a scale to measure the extent of consciousness, based on eye, verbal and motor responses to specific prescribed sound and pain stimuli.
Purpose
The GCS score provides the opportunity to document a clinical observation of a patient’s conscious state with a validated instrument which makes use of a patient’s responses to stimuli.
Evidence Base
The Glasgow Coma Scale is used to evaluate a patient’s consciousness by means of three elements:
opening eyes (eye response);
answering questions (verbal response);
motor response.
The three response values are looked at individually and as a whole. The total is referred to as the EMV score. The minimum total score is 3 and the maximum is 15. A slightly altered scale is used for infants (age 0-2) and toddlers (age 2-5).
The EMV score can be expressed as a combination of each of the three individual scores, such as: E3M2V4 (opens eyes when spoken to, arms stretch in response to pain and patient produces incomprehensible sounds).
If one of the EMV elements cannot be evaluated - such as might be the case if a patient is intubated and incapable of verbally responding, or is paralyzed/weak and incapable of fulfilling the motor request, then the individual score is included (score 1), but with an extra comment.
V1T is used for an intubated patient, in which t = 'tube'.
Clinical decisions must be based on each of the specific data of the eyes, motor and verbal responses and, if evaluation is not possible, an explicit explanation.
Standard values for the total score, depending on age:
0-6 months : 9 and up
6-12 months : 11 and up
1-2 : 12 and up
2-5 : 13 and up
> 5 : 14 and up
Information Model
Type
Id
Concept
Card.
Definition
DefinitionCode
Reference
NL-CM:12.8.1
GlasgowComaScale
Root concept of the GlasgowComaScale building block. This root concept contains all data elements of the GlasgowComaScale building block.
386554004 Glasgow coma scale (assessment scale)
NL-CM:12.8.8
GlasgowComaScaleDateTime
1
Time at which the EMV score was determined.
NL-CM:12.8.2
GCS_Eyes
0..1
Best eye response to a stimulus. The element is mandatory, but does not require a numerical value. If no value is given, the reason for this is to be provided in the ExplanationEScore concept.
281395000 Glasgow coma score eye opening subscore (observable entity)
Reason why no eye response test could be done. This is to be entered as free text. An often-used notation is the abbreviation c (closed), in the event that the eyes are closed.
NL-CM:12.8.4
GCS_Motor
0..1
Best motor response to a stimulus. The element is mandatory, but does not require a numerical value. If no value is given, the reason for this is to be provided in the ExplanationMScore concept.
281396004 Glasgow Coma Score motor response subscore
Reason why no motor response test could be done. This is to be entered as free text.
NL-CM:12.8.6
GCS_Verbal
0..1
Best verbal response to a stimulus. The element is mandatory, but does not require a numerical value. If no value is given, the reason for this is to be provided in the ExplanationVScore concept.
281397008 Glasgow coma score verbal response subscore (observable entity)
Reason why no verbal response test could be done. This is to be entered as free text.
An often-used notation is the addition 'Tube' for an intubated patient.
NL-CM:12.8.10
TotalScore
0..1
The sum of the EMV scores, expressed as a number on a scale from 3-15. The value does not have to be recorded, as it can always be calculated based on the individual scores, and as recording the total is not common for a difficult to determine individual score.
NL-CM:12.8.9
Explanation
0..1
Comment on (the context of) the EMV score measurement, such as any problems or factors that may influence interpretation.
Columns Concept and DefinitionCode: hover over the values for more information
For explanation of the symbols, please see the legend page
Example Instances
Only available in Dutch
GlasgowComaScaleDatumTijd
GCS_Eyes
GCS_Motor
GCS_Verbal
TotaalScore
Toelichting
08-02-2013 6:43
2
4
5
11
Beste score voor intubatie, kleding stond in brand
GlasgowComaScaleDatumTijd
GCS_Eyes
GCS_Motor
GCS_Verbal
TotaalScore
Toelichting
07-02-2013 11:34
4
4
1
Lijkt adequaat
GlasgowComaScaleDatumTijd
GCS_Eyes
GCS_Motor
GCS_Verbal
TotaalScore
Toelichting
07-02-2013 8:00
1
1
1
3
Zonder spierverslappers na 2 uur reanimatie
References
1. openEHR-EHR-OBSERVATION.glasgow_coma.v1[Online] Beschikbaar op: http://www.openehr.org/knowledge/ [Geraadpleegd: 23 februari 2015].
To exchange information based on health and care information models, additional, more technical specifications are required.
Not every environment can handle the same technical specifications. For this reason, there are several types of technical specifications:
HL7® version 3 CDA compatible specifications, available through the Nictiz ART-DECOR® environment
HL7® FHIR® compatible specifications, available through the Nictiz environment on the Simplifier FHIR
The information in this wikipage is based on Registratie aan de bron publication 2015 including errata dd. 16-07-2015
Conditions for use are located on the mainpage
This page is generated on 24/01/2018 17:12:20
GlasgowComaScale
GlasgowComaScaleDateTime
or as spreadsheet 