Attention!! This is not the most recent version of this information model. You can find the most recent version
''here''.
General information
Name: nl.zorg.GlasgowComaScale 
Version: 3.3
HCIM Status:Final
Release: 2022
Release status: Prepublished
Release date: 15-10-2023
Metadata
| DCM::CoderList |
Kerngroep Registratie aan de Bron
|
| DCM::ContactInformation.Address |
*
|
| DCM::ContactInformation.Name |
*
|
| DCM::ContactInformation.Telecom |
*
|
| DCM::ContentAuthorList |
Projectgroep Generieke Overdrachtsgegevens & Kerngroep Registratie aan de Bron
|
| DCM::CreationDate |
29-11-2012
|
| DCM::DeprecatedDate |
|
| DCM::DescriptionLanguage |
nl
|
| DCM::EndorsingAuthority.Address |
|
| DCM::EndorsingAuthority.Name |
PM
|
| DCM::EndorsingAuthority.Telecom |
|
| DCM::Id |
2.16.840.1.113883.2.4.3.11.60.40.3.12.8
|
| DCM::KeywordList |
Glascow coma schaal
|
| DCM::LifecycleStatus |
Final
|
| DCM::ModelerList |
Kerngroep Registratie aan de Bron
|
| DCM::Name |
nl.zorg.GlasgowComaScale
|
| DCM::PublicationDate |
15-10-2023
|
| DCM::PublicationStatus |
Prepublished
|
| DCM::ReviewerList |
Projectgroep Generieke Overdrachtsgegevens & Kerngroep Registratie aan de Bron
|
| DCM::RevisionDate |
28-10-2021
|
| DCM::Supersedes |
nl.zorg.GlasgowComaScale-v3.2
|
| DCM::Version |
3.3
|
| HCIM::PublicationLanguage |
EN
|
Revision History
Only available in Dutch
Publicatieversie 1.0 (15-02-2013)
-
Publicatieversie 1.1 (01-07-2013)
-
Publicatieversie 1.2 (01-04-2015)
Issue summaries niet beschikbaar
Bevat: ZIB-227, ZIB-228, ZIB-229, ZIB-230, ZIB-231, ZIB-232, ZIB-308, ZIB-311, ZIB-361.
Incl. algemene wijzigingsverzoeken:
ZIB-94, ZIB-154, ZIB-200, ZIB-201, ZIB-309, ZIB-324, ZIB-326.
Publicatieversie 1.2.1 (16-07-2015)
Bevat: ZIB-414.
Publicatieversie 3.0 (01-05-2016)
Bevat: ZIB-453
Publicatieversie 3.1 (04-09-2017)
Bevat: ZIB-431, ZIB-466, ZIB-564.
Publicatieversie 3.2 (01-09-2020)
Bevat: ZIB-1050, ZIB-1085.
Publicatieversie 3.3 (01-12-2021)
Bevat: ZIB-1314.
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 NT), with an extra comment. Er moet dan GEEN totaalscore worden doorgegeven.
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 months: 10 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 information model. This root concept contains all data elements of the GlasgowComaScale information model.
|
|
|
|
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 ConditionsDuringMeasurement concept.
|
| 281395000 Glasgow Coma Score eye opening subscore
|
|
|
|
|
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 ConditionsDuringMeasurement concept.
|
| 281396004 Glasgow Coma Scale motor response subscore
|
|
|
|
|
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 ConditionsDuringMeasurement concept.
|
| 281397008 Glasgow Coma Scale verbal response subscore
|
|
|
|
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:12.8.11
|
|
ConditionsDuringMeasurement
|
0..*
|
Conditions during the measurement that prevent one or more of the subscores from being determined (non testable), such as,e.g. intubation during testing of GCS_Verbal.
|
|
|
|
NL-CM:12.8.9
|
|
Comment
|
0..1
|
Comment on (the context of) the EMV score measurement, such as any problems or factors that may influence interpretation.
|
| 48767-8 Annotation comment [Interpretation] Narrative
|
|
|
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
Voorbeeld file fout: Unable to find the specified file. : nl.zorg.GlasgowComaScale-v3.3(NL)_Voorbeeld.docx
References
- Glasgow Coma Scale (GCS) [Online] op https://www.openehr.org/ckm/ [Geraadpleegd: 22 mei 2020].
- Paediatric Glasgow Coma Scale (pGCS) [online] beschikbaar viahttps://www.openehr.org/ckm/ [Geraadpleegd: 22 mei 2020].
- Performance of the Pediatric Glasgow Coma Scale Score in the Evaluation of Children With Blunt Head Trauma, Dominic A. Borgialli, et. all. 2016 by the Society for Academic Emergency Medicine, doi: 10.1111/acem.13014
<lihttps://www.glasgowcomascale.org [geraadpleegd: 22 mei 2020]
Valuesets
ConditionsDuringMeasurementCodelist
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.12.8.6
|
Binding: Extensible
|
| Conceptname
|
Conceptcode
|
Codesystem name |
Codesystem OID
|
Description
|
| Sedated
|
17971005
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
gesedeerd
|
| Paralysis caused by skeletal muscle relaxant
|
40241000146103
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
spierverslappers
|
| Aphasia
|
87486003
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
afasie
|
| Endotracheal tube present
|
419991009
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
tube aanwezig
|
| Tracheostomy present
|
302108003
|
SNOMED CT
|
2.16.840.1.113883.6.96
|
tracheostoma aanwezig
|
| other
|
OTH
|
NullFlavor
|
2.16.840.1.113883.5.1008
|
anders
|
GCS_EyesCodelist
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.12.8.1
|
Binding: Required
|
| Conceptname
|
Conceptcode
|
Conceptvalue
|
Codesystem name |
Codesystem OID
|
Description
|
| Spontaneous
|
E4
|
4
|
GCS_Eyes
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.1
|
Spontaan [De ogen worden geopend zonder aansporing
|
| To sound
|
E3
|
3
|
GCS_Eyes
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.1
|
Bij aanspreken of aanroepen [De ogen worden pas geopend op aanspreken van de patiënt]
|
| To stimuli
|
E2
|
2
|
GCS_Eyes
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.1
|
Bij een prikkel [De ogen worden pas geopend na geven van een fysieke prikkel]
|
| No response
|
E1
|
1
|
GCS_Eyes
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.1
|
Geen reactie [De ogen blijven gesloten onder elke omstandigheid]
|
| Not applicable
|
NA
|
0
|
NullFlavor
|
2.16.840.1.113883.5.1008
|
Niet testbaar door een lokale beperkende factor
|
GCS_MotorCodelist
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.12.8.2
|
Binding: Required
|
| Conceptname
|
Conceptcode
|
Conceptvalue
|
Codesystem name |
Codesystem OID
|
Description
|
| Obeys
|
M6
|
6
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Voert opdracht uit [Een eenvoudig bevel wordt uitgevoerd]
|
| Localises pain
|
M5
|
5
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Lokaliseren [In staat zijn de pijn duidelijk te lokaliseren]
|
| Withdrawal response
|
M4
|
4
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Terugtrekken [In staat om een afwerende of wegtrekkende beweging te maken op een pijnprikkel]
|
| Flexor response
|
M3
|
3
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Buigreactie [Armen en handen op krampachtige manier geplooid. Meestal benen gestrekt.]
|
| Extensor response
|
M2
|
2
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Strekreactie [Armen en handen op krampachtige manier geplooid met naar buiten gedraaide hand. Mogelijk alle spieren van het lichaam gespannen]
|
| No response
|
M1
|
1
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Geen reactie op pijnprikkel [Geen enkele lichamelijke reactie beweging op een pijnprikkel]
|
| Not applicable
|
NA
|
0
|
NullFlavor
|
2.16.840.1.113883.5.1008
|
Not applicable
|
GCS_MotorCodelistBaby
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.12.8.8
|
Binding: Required
|
| Conceptname
|
Conceptcode
|
Conceptvalue
|
Codesystem name |
Codesystem OID
|
Description
|
| Moves spontaneously and purposefully
|
M6B
|
6
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Normaal [beweegt zoals verwacht]
|
| Withdraws to touch
|
M5B
|
5
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Terugtrekken bij aanraking [Trekt terug bij aanraken]
|
| Withdraws to pain
|
M4B
|
4
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Terugtrekken in respons op pijn [Maakt afwerende of wegtrekkende beweging bij een pijnprikkel]
|
| Flexor response
|
M3
|
3
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Buigreactie [Langzame, buiging van armen en/of benen]
|
| Extensor response
|
M2
|
2
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Decerebrale strekreactie [strekken van armen en/of benen]
|
| No response
|
M1
|
1
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Geen beweging op prikkel [Geen enkele beweging op een prikkel]
|
| Not applicable
|
NA
|
0
|
NullFlavor
|
2.16.840.1.113883.5.1008
|
Niet van toepassing
|
GCS_MotorCodelistToddler
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.12.8.7
|
Binding: Required
|
| Conceptname
|
Conceptcode
|
Conceptvalue
|
Codesystem name |
Codesystem OID
|
Description
|
| Obeys
|
M6
|
6
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Voert opdracht tot bewegen uit [Een eenvoudig verzoek tot bewegen wordt uitgevoerd]
|
| Localises pain
|
M5
|
5
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Terugtrekken bij aanraking [Trekt terug bij aanraken]
|
| Withdrawal response
|
M4
|
4
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Terugtrekken in respons op pijn [Maakt afwerende of wegtrekkende beweging bij een pijnprikkel]
|
| Flexor response
|
M3
|
3
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Buigreactie [Langzame, buiging van armen en/of benen]
|
| Extensor response
|
M2
|
2
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Decerebrale strekreactie [strekken van armen en/of benen]
|
| No response
|
M1
|
1
|
GCS_Motor
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.2
|
Geen beweging op prikkel [Geen enkele beweging op een prikkel]
|
| Not applicable
|
NA
|
0
|
NullFlavor
|
2.16.840.1.113883.5.1008
|
Niet van toepassing
|
GCS_VerbalCodelist
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.12.8.3
|
Binding: Required
|
| Conceptname
|
Conceptcode
|
Conceptvalue
|
Codesystem name |
Codesystem OID
|
Description
|
| Oriented
|
V5
|
5
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Georiënteerd [Helder en duidelijk bewust van de situatie]
|
| Confused
|
V4
|
4
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Verward [Verwarde conversatie maar wel in staat om te antwoorden op de vragen]
|
| Inappropriate speech
|
V3
|
3
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Inadequaat [Woorden zijn te verstaan maar vormen geen zinnen]
|
| Incomprehensible sounds
|
V2
|
2
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Onverstaanbaar [De spraak is niet te verstaan]
|
| No response
|
V1
|
1
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Geen reactie [Geen enkel verbale respons]
|
| Not applicable
|
NA
|
0
|
NullFlavor
|
2.16.840.1.113883.5.1008
|
Not applicable
|
GCS_VerbalCodelistBaby
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.12.8.5
|
Binding: Required
|
| Conceptname
|
Conceptcode
|
Conceptvalue
|
Codesystem name |
Codesystem OID
|
Description
|
| Coos/babbles
|
V5B
|
5
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Kirt/brabbelt
|
| Irritatable cries
|
V4B
|
4
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Huilt prikkelbaar
|
| Cries to pain
|
V3B
|
3
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Huilt van de pijn
|
| Moans
|
V2B
|
2
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Jammert/kreunt
|
| No response
|
V1
|
1
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Geen reactie [Geen enkel verbale response]
|
| Not applicable
|
NA
|
0
|
NullFlavor
|
2.16.840.1.113883.5.1008
|
Not applicable
|
GCS_VerbalCodelistToddler
| Valueset OID: 2.16.840.1.113883.2.4.3.11.60.40.2.12.8.4
|
Binding: Required
|
| Conceptname
|
Conceptcode
|
Conceptvalue
|
Codesystem name |
Codesystem OID
|
Description
|
| Oriented
|
V5
|
5
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Adequate woorden en zinnen [Woorden of kleine zinnen in context van de situatie]
|
| Confused
|
V4
|
4
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Onjuiste woorden [Verwarde woorden]
|
| Inappropriate speech
|
V3
|
3
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Huilen [Aanhoudend huilen of krijsen]
|
| Incomprehensible sounds
|
V2
|
2
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Kreunen [Alleen kreunen]
|
| No response
|
V1
|
1
|
GCS_Verbal
|
2.16.840.1.113883.2.4.3.11.60.40.4.2.3
|
Geen reactie [Geen enkel verbale response]
|
| Not applicable
|
NA
|
0
|
NullFlavor
|
2.16.840.1.113883.5.1008
|
Not applicable
|
This information model in other releases
Information model references
This information model refers to
- --
This information model is used in
- --
Technical specifications in HL7v3 CDA and HL7 FHIR
To exchange information based on health and care information models, additional, more technical specifications are required.<BR>
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
Downloads
This information model is also available as pdf file 
or as spreadsheet 
About this information
The information in this wikipage is based on Pre-release 2022-1
SNOMED CT and LOINC codes are based on:
- SNOMED Clinical Terms versie: 20230930 [R] (september 2023-editie)
- LOINC version 2.76
Conditions for use are located on the mainpage
This page is generated on 27/03/2024 11:09:32 with ZibExtraction v. 9.3.8851.20230
