GCS_VerbalCodelijstBaby en Kleuter hebben verschillende V10
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.
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.
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
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
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.
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.
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
Technical specifications in HL7v3 CDA and HL7 FHIR
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
GlasgowComaScale
GlasgowComaScaleDateTime
or as spreadsheet 