🎓‼ Earn CE Credits! Pre-order ICU Advantage Academy: 👉🏼 adv.icu/academy 💲 10% off Critical Care Academy (CCRN Review): 👉🏼adv.icu/cca (USE CODE "icuadv10") 💲 10% off EACH Month @ Nurisng Mastery membership: 👉🏼 adv.icu/mastery 📝 NOTES available to members! ► UA-cam: adv.icu/ym | ► Patreon: adv.icu/pm Thank you guys so much for watching! Please leave us a like if you enjoyed the video. We truly do appreciate it! Also we love hearing your comments so feel free to tell us what you think of the video. We hope that after this lesson, you will have a good understanding of the simple yet effective and powerful assessment tool called the Glasgow Coma Scale. This assessment will likely be something you perform multiple times a day on each of your patients and you can really utilize this to monitor for the first signs of deterioration in your patients. Don't forget to check us out and give us a like on Instagram as well! instagram.com/ICUAdvantage
On May 25th last year I was in a road accident. I was wearing my gear so there were no external injuries but my lungs were filled with blood and my brain was bleeding from 5 places from what I understood. My discharge summary says I had a GCS of 5 when I was admitted to the ICU. After watching this I understand why all the doctors said it's a miracle I'm still alive let alone the fact that I have no disabilities and still able to function normally. Got lucky! Phew!!
@@ivmean1120 I woke up later on the same day or early morning next day. But they tell me I couldn't process the information of where I am and what happened and I thought my life was in danger and tried to chew my way through the ventilator pipe and the restraints, so they sedated me. I was kept sedated for I think 2 days. After that I had calmed down and although I had lost all my memories I understood that I was in an accident and I wasn't trying to break through anything and run. I did have panic attacks at times but my family was there by that time and they would be asked to step into ICU and calm me down.
Great video, very informative. Explanation was in full, and spot on. I suffered an cerebral aneurysm (SAH) 2009. Following my statement that I had the worst HA in my lifetime, I immediately lost consciousness. Upon arrival of EMS, their eval revealed I was GCS 3. I was airlifted to larger city, developed swelling (angry brain), had coil surgery 3 days later, and was in a coma for 27 days. Following 6 weeks of Phys Rehab, I now walk with a quad cane (balance issues), drive, can do most ADL's without many problems. I cannot write, I also have speech issues, but can read aloud with no trouble. So yes, I bounced back from my GCS of 3. Don't count us out too soon!
Amazing story. Thanks for sharing! Absolutely right about not counting someone out based solely on GCS, especially early in an injury! It's amazing the recoveries we see sometimes!
I'm so glad you are making a recovery! At my church a young lady complained of a horrible headache, collapsed and never woke up. Left behind 3 small children she was homeschooling
Well I am an RN and wound up coding 3 days after cardiac bypass surgery from an allergic reaction and spent 4 days tubed and woke up on a vent and thought I was kidnapped and they were trying to kill me.😱 Well, I am reading through my chart and they scored me 11 while tubed and was trying to figure out how they scored me 11 and my dr ordered rass score of -2. And I opend up utube and there was your lesson on GCS. PERFECT!🎯Thanks for the education!
i was the loser in a motorcycle-on-SUV accident back in 2012, i sustained a severe diffuse axonal injury with the concentration of the impact being to my prefrontal cortex. i came into the hospital at a 3 on this scale. cadavers score a GCS3. i credit neurofeedback with a great deal of my cognitive recovery, but.. honestly i shouldn't even still be here to tell my story. there's a video on here somewhere about my recovery
thanks for this! I've been coding (trauma registrar) for 6+ years now with no background in paramedic/EMT, no nursing, etc. Even though i understand this scale at its basic functionality, this is great information. When reading & assessing documentation, you can see why a patient is given the score they were given. Also, you can ask if you notice any disparities (for clarification, etc.). It's also great to go over things already known as a refresher - or, in case you may have missed anything previously. Cheers!
I'm an EMT and headed to a BSN and hopefully an NP one day! This video has been so incredibly helpful. Thank you for taking the time to create this video. ❤ I am subscribed and binging your videos now!
So glad to help in making these videos! Awesome journey you are on there. One day at a time and you'll get there. So cool. Glad you liked it and welcome aboard!
Been binge-watching your videos! Really appreciate you and what you have done! Would love to see videos on more in-depth neuro assesment (i.e. MEND assesment), managing pts with TBIs, and differences between different LOCs (stupor, obtundation, semi-comatose, comatose, etc.)!
Thank you so much and I'm really glad you enjoy these videos! I certainly plan to do more neuro related topics in the future. Not sure of a timeline for anything yet, but they definitely are on the todo list for the future!
Hi! Current second year grad student and future speech-language pathologist here! This really helped me while studying for the Praxis and my comprehensive exam. Thank you!
Thank you so much! This video is very helpful, i got so confused about gcs before and sometimes get decorticate and decebrate messed up. After watching this i can totally understand now
Thanks for the very informative video!! :) I had a confused patient whom I had to check GCS. And the patient was E4, V4 but for motor response, he did not follow my command when I asked him to move his arms. Instead, he frustratingly gave me the bad middle finger! Lol! I just charted exactly what he did.
Ahhh yes, the good 'ol 1 finger assessment that your patient is still in there. :) I recall getting that one time while the family was in there and everyone was so excited and happy to see him give me the bird! haha. Glad you enjoyed the video though and thanks for sharing the story!
So incredibly helpful! I’m so grateful (and I know I’m not alone!) in your thoughtful and well-done explanations of subjects we need to know about as nurses. Thanks again and bless you!
Quick question. If the patient only opens their eyes to verbal stimulus, makes incomprehensible sounds, and withdraws from pain, what is the score actually be 9? I am having trouble understanding why the score for eye-opening would be 4 if they only open their eyes to verbal stimulus, which would be 3. If I am misunderstanding please let me know.
I’m approaching my 25th year past my injury and it wasn’t until last year I learned how rare it is for someone who was a GCS 3 at the scene of the accident to have recovered to my level. I was treated at one of the top hospitals at the time for TBIs. (It happened to be the closest one to my accident.) I am more than fortunate in my treatment. Also how my epilepsy began inside the CT scanner upon arrival.
Upon arrival at the hospital I was a 7. I still have the records I ordered for my Paralegal Education later. I was a E3, V2 and M2. Wild! Thank you very much. I can finally understand with better detail what this means. My doctor friend described the M2 as very bad, but I didn’t understand exactly how and why. I now have a permanent vestibular migraine condition that didn’t begin until 14 years later. I believe it has something to do with this and the blood found in the occipital lobe immediately following my injury.
Wow thank you so much for sharing. I'm so sorry to hear that you had to go through this all those years ago, but also glad to hear that you were fortunate enough to find your way in to great care and are still here to be able to share your story. It sounds like it has been a difficult journey for you but you seem to have a great attitude. I wish you all the best and take care!
Without my struggles I wouldn’t be the person I am today. My favorite saying is that: “We’ve all got something.” Whenever anyone freaks out and says that I’ve had it so much worse than anything they’ve experienced, I try to pull them back with this sentence. I cannot imagine how hard it must be to raise children alone and try to work full time. I cannot imagine how hard it must be to have a husband or wife leave the scene and need to explain this to little kids or even the older children. There is plenty I have no idea what it’s like to have happen in my life. I am also very fortunate to know why I have epilepsy. The majority of epilepsy patients have no idea. My only problem is mine is completely uncontrollable. It’s slowly and slowly becoming better managed, but it’s still disabling.
Excellent video. Thank you for posting. This will be very helpful with the distant learning many nursing schools are doing during this time of social isolation r/t COVID 19
Hello Good day! Just a question if a patient is intubated but fully awake pointing something / instruction something to health care provider that can't determine what it is.. In Verbal assessment, does it fall on INCOMPREHENSIVE WORDS?
Thank you for the video! How if the patient only withdraw to pain over the lower limbs and not upper limbs? Will you still consider it as M4? How to assess if patient have one side weakness since their other side cannot not localised pain like Normal patient?
It doesn't matter what side or how many limbs or whatever. You take the best score that you observe. Oftentimes in brain injured patients we will not have symmetry or have dysfunction in what patients are capable of doing. That said, if you can only withdraw from pain on one limb, you are still withdrawing from pain. Make sense?
Thank you. Its not upper over lower, its just the best response that you get you would score that. So if it was lower and that was better than upper, you'd score off the lower.
4. A 21 year-old male was rushed to emergency room due to road traffic accident. He is gasping for breath and has wound on head and upper extremities, swollen (R) leg, unable to open mouth for bite and raise extremities when asked and complains of severe pain. Based on the scenario, compute the GCS score of the client using the 3 scales.؟
how about patients who has severe tbi injuries who eyes just never close ? still a 4 an E also how can I tell if something is abnormal posturing or its contractures.. also some contractures does not allow patients to move abnormally to painful stimuli. how do I assess this and document?
@@ICUAdvantage thanks is not enough for people like you who cares about saving People's lives and making our jobs easier. It goes a long way! Many, many thanks!
@@ICUAdvantage the OSCE is a final year nursing physical exam we have to conduct on a "patient" in a simulation here in Australia. We have a patient that deteriorates and one of the scenarios we may get is a patient that becomes confused and declines and we have to recognise this and conduct a full GCS.
Glad you liked it. And yeah, I put a correction in the video description. I for some reason wrote 4 while saying 3. 3 is correct. Total score of 9, not 10.
Hi, I am enquiring about coma states in view of my cousin's recent medically induced coma at the Heidelberg University Hospital. Thx for such a great video. I got the jist of most of it and understood the clear layman's explanation style. I wonder then, is the GCS relevant only to comas induced naturally? Have I missed anything regarding medically induced comas? If so then would you pls point me in the right direction so my family can have informed discussions with the hospital in the next few days. All the best.
Q - If fine motor muscle movement is lost i.e- Fingers curl and won't straighten or coordinate but abnormal limb flexion/isn't decorticating, would that be considered a M4 please?
We are just assessing if and how they open their eyes. No need for a pen light or to assess pupil size. Just looking at if they will open their eyes, spontaneously, to voice, to pain, or not at all. Thanks for the question!
If a patient is making some growing sounds spontaneously n openingeyes, but sometimes not showing any visual or verbal response to stimulus. Showing some flexor withdrawal to pain full stimulus. And she is on de corticate posture what could be her GCS. .
A score is a moment in time and especially with brain injury, this will wax and wane. Just score it based on what you assess at that time. If its a big change down, let the providers know in case there is something causing that change that needs to be addressed.
Good video... Have my OSCE tomorrow so has helped me alot. Only thing as a glaswegian the way you say Glasgow annoys me 😂 sounds like glass-go when you're saying it 😬😂
As far as the GCS score goes, we'd want to score the highest that we get for a category, so since the posturing is only unilateral, I'd score the higher score that the other side does. The unilateral posturing is typically a localized lesion/edema that is only impacting part of the lower brain. For the score, grimacing and HR don't play in to it, but can be valuable information as it probably signifies high level response to pain. Is there no eye opening or vocalization? Hope that helps and thanks for taking the time to ask the question!
@@ICUAdvantage I'm sorry, let me explain in detail. He had hemmorage in his brain in his third and fourth ventricle. He displayed mild decerebrate posture in both arms. His heart rate would increase upon hearing certain voices and if you moved him around he would frown. He showed mild flexion. If you scratched his feet he would move a little. Slight Gag reflux was present. He could take some breaths on his own but need ventilators. If ventilator was removed he have rapid breathing. They couldn't remove the hematoma with the drainage catheter and refused to do surgery. In this case is there any hope
Dear my brother and Sister my czn is get accident and right now he is in 7/15 plz guys tell me its possible they can recover ... plz i am waiting for your guys reply thanks . Alot
I don't understand. How are you getting dislikes? Do they not like the colors? The detailed information? Or did they suffer from "mouse pad malfunctions"? LOL
🎓‼ Earn CE Credits! Pre-order ICU Advantage Academy: 👉🏼 adv.icu/academy
💲 10% off Critical Care Academy (CCRN Review): 👉🏼adv.icu/cca (USE CODE "icuadv10")
💲 10% off EACH Month @ Nurisng Mastery membership: 👉🏼 adv.icu/mastery
📝 NOTES available to members! ► UA-cam: adv.icu/ym | ► Patreon: adv.icu/pm
Thank you guys so much for watching! Please leave us a like if you enjoyed the video. We truly do appreciate it! Also we love hearing your comments so feel free to tell us what you think of the video. We hope that after this lesson, you will have a good understanding of the simple yet effective and powerful assessment tool called the Glasgow Coma Scale. This assessment will likely be something you perform multiple times a day on each of your patients and you can really utilize this to monitor for the first signs of deterioration in your patients.
Don't forget to check us out and give us a like on Instagram as well! instagram.com/ICUAdvantage
I’m in nursing school and this is the best video I’ve seen for GCS. I’ve been really enjoying your videos.
On May 25th last year I was in a road accident. I was wearing my gear so there were no external injuries but my lungs were filled with blood and my brain was bleeding from 5 places from what I understood. My discharge summary says I had a GCS of 5 when I was admitted to the ICU. After watching this I understand why all the doctors said it's a miracle I'm still alive let alone the fact that I have no disabilities and still able to function normally. Got lucky! Phew!!
WOW! That is an amazing recovery! So glad to hear this!
@shrilayt. How long that you awake from the coma?
@@ivmean1120 I woke up later on the same day or early morning next day. But they tell me I couldn't process the information of where I am and what happened and I thought my life was in danger and tried to chew my way through the ventilator pipe and the restraints, so they sedated me. I was kept sedated for I think 2 days. After that I had calmed down and although I had lost all my memories I understood that I was in an accident and I wasn't trying to break through anything and run. I did have panic attacks at times but my family was there by that time and they would be asked to step into ICU and calm me down.
@@shrilayt Medical Miracles still occur!
It is really a miracle. It is the power of love of your loving ones.
Great video, very informative. Explanation was in full, and spot on. I suffered an cerebral aneurysm (SAH) 2009. Following my statement that I had the worst HA in my lifetime, I immediately lost consciousness. Upon arrival of EMS, their eval revealed I was GCS 3. I was airlifted to larger city, developed swelling (angry brain), had coil surgery 3 days later, and was in a coma for 27 days. Following 6 weeks of Phys Rehab, I now walk with a quad cane (balance issues), drive, can do most ADL's without many problems. I cannot write, I also have speech issues, but can read aloud with no trouble. So yes, I bounced back from my GCS of 3. Don't count us out too soon!
Amazing story. Thanks for sharing! Absolutely right about not counting someone out based solely on GCS, especially early in an injury! It's amazing the recoveries we see sometimes!
I'm so glad you are making a recovery! At my church a young lady complained of a horrible headache, collapsed and never woke up. Left behind 3 small children she was homeschooling
@UC5ADeLt8ckSBvfz0C47qbGQ
The only video so far that talks in detail about the difference between types of abnormal verbal responses and abnormal motor responses.
Thank you!
Glad to be able to help! :)
Well I am an RN and wound up coding 3 days after cardiac bypass surgery from an allergic reaction and spent 4 days tubed and woke up on a vent and thought I was kidnapped and they were trying to kill me.😱 Well, I am reading through my chart and they scored me 11 while tubed and was trying to figure out how they scored me 11 and my dr ordered rass score of -2.
And I opend up utube and there was your lesson on GCS. PERFECT!🎯Thanks for the education!
in the first example you gave at minute 22:12: it should be E3,V2,M4 = 9.
Oh my gosh! Great catch! I didn't even catch that in editing. No clue why I wrote E4 after just stating it was 3... Thank you for catching that! 👏
i was the loser in a motorcycle-on-SUV accident back in 2012, i sustained a severe diffuse axonal injury with the concentration of the impact being to my prefrontal cortex. i came into the hospital at a 3 on this scale. cadavers score a GCS3. i credit neurofeedback with a great deal of my cognitive recovery, but.. honestly i shouldn't even still be here to tell my story. there's a video on here somewhere about my recovery
thanks for this! I've been coding (trauma registrar) for 6+ years now with no background in paramedic/EMT, no nursing, etc. Even though i understand this scale at its basic functionality, this is great information. When reading & assessing documentation, you can see why a patient is given the score they were given. Also, you can ask if you notice any disparities (for clarification, etc.). It's also great to go over things already known as a refresher - or, in case you may have missed anything previously. Cheers!
I'm an EMT and headed to a BSN and hopefully an NP one day! This video has been so incredibly helpful. Thank you for taking the time to create this video. ❤ I am subscribed and binging your videos now!
So glad to help in making these videos! Awesome journey you are on there. One day at a time and you'll get there. So cool. Glad you liked it and welcome aboard!
@@ICUAdvantage 😁😁😁 thank you!
Our Midterm examination is about to come that is why I am here. This video is very helpful. Thank you for your virtual help.❣
My pleasure and best of luck on your exam!
Extra Value Meal costs $4.56
Eyes-4
Verbal-5
Motor- 6
Nice!
Been binge-watching your videos! Really appreciate you and what you have done!
Would love to see videos on more in-depth neuro assesment (i.e. MEND assesment), managing pts with TBIs, and differences between different LOCs (stupor, obtundation, semi-comatose, comatose, etc.)!
Thank you so much and I'm really glad you enjoy these videos!
I certainly plan to do more neuro related topics in the future. Not sure of a timeline for anything yet, but they definitely are on the todo list for the future!
Hi! Current second year grad student and future speech-language pathologist here! This really helped me while studying for the Praxis and my comprehensive exam. Thank you!
How cool! Glad this helped Rachel!
@@ICUAdvantage Update: I passed the PRAXIS! Thanks!
Great job. I'm finally on my internship on icu and your videos are just amazing. Thank you so much.
Thank you so much! This video is very helpful, i got so confused about gcs before and sometimes get decorticate and decebrate messed up. After watching this i can totally understand now
Yes!!! So happy to hear this!
Amazing!! I finally understand. Thank you🤎
Thanks for the very informative video!! :) I had a confused patient whom I had to check GCS. And the patient was E4, V4 but for motor response, he did not follow my command when I asked him to move his arms. Instead, he frustratingly gave me the bad middle finger! Lol! I just charted exactly what he did.
Ahhh yes, the good 'ol 1 finger assessment that your patient is still in there. :) I recall getting that one time while the family was in there and everyone was so excited and happy to see him give me the bird! haha.
Glad you enjoyed the video though and thanks for sharing the story!
So incredibly helpful! I’m so grateful (and I know I’m not alone!) in your thoughtful and well-done explanations of subjects we need to know about as nurses. Thanks again and bless you!
Appreciate that Aaron. Truly a labor of love haha. Glad the videos are well received!
Quick question. If the patient only opens their eyes to verbal stimulus, makes incomprehensible sounds, and withdraws from pain, what is the score actually be 9? I am having trouble understanding why the score for eye-opening would be 4 if they only open their eyes to verbal stimulus, which would be 3. If I am misunderstanding please let me know.
Very important video that we get good information about GCS scale
Really it's too helpful,you made in easy way to understand
Glad to hear that!
This was super helpful for my EMT class. Thanks, this helped me a lot!
So glad you enjoyed the video Aubrey!
I’m approaching my 25th year past my injury and it wasn’t until last year I learned how rare it is for someone who was a GCS 3 at the scene of the accident to have recovered to my level. I was treated at one of the top hospitals at the time for TBIs. (It happened to be the closest one to my accident.) I am more than fortunate in my treatment. Also how my epilepsy began inside the CT scanner upon arrival.
Upon arrival at the hospital I was a 7. I still have the records I ordered for my Paralegal Education later. I was a E3, V2 and M2. Wild! Thank you very much. I can finally understand with better detail what this means. My doctor friend described the M2 as very bad, but I didn’t understand exactly how and why. I now have a permanent vestibular migraine condition that didn’t begin until 14 years later. I believe it has something to do with this and the blood found in the occipital lobe immediately following my injury.
Despite the many surgeries I’m now on SSDI because of my epilepsy. Life is something, eh?
Wow thank you so much for sharing. I'm so sorry to hear that you had to go through this all those years ago, but also glad to hear that you were fortunate enough to find your way in to great care and are still here to be able to share your story. It sounds like it has been a difficult journey for you but you seem to have a great attitude. I wish you all the best and take care!
Without my struggles I wouldn’t be the person I am today. My favorite saying is that: “We’ve all got something.” Whenever anyone freaks out and says that I’ve had it so much worse than anything they’ve experienced, I try to pull them back with this sentence. I cannot imagine how hard it must be to raise children alone and try to work full time. I cannot imagine how hard it must be to have a husband or wife leave the scene and need to explain this to little kids or even the older children. There is plenty I have no idea what it’s like to have happen in my life. I am also very fortunate to know why I have epilepsy. The majority of epilepsy patients have no idea. My only problem is mine is completely uncontrollable. It’s slowly and slowly becoming better managed, but it’s still disabling.
I was a 3, after a fatal car accident on the highway, God bless.
Excellent video. Thank you for posting. This will be very helpful with the distant learning many nursing schools are doing during this time of social isolation r/t COVID 19
Professional and clearly explained
Very much appreciate the feedback! Thank you and glad you enjoyed!
That's an amazing video for us clinicians ❤❤❤
Wonderfully explained to make it easy and for interpretation of the scores.
Happy to hear this!
Quick question, how come we don’t score for pupils reaction to light when we have to check this? This video is so helpful thank you !
Hello Good day! Just a question if a patient is intubated but fully awake pointing something / instruction something to health care provider that can't determine what it is.. In Verbal assessment, does it fall on INCOMPREHENSIVE WORDS?
subscribed! totally helped me for my GCS reporting for our ICU rotation! thanks a lot
So great to hear this! Happy to be able to help.
Thank you so much for your videos. They are very well done and extremely helpful to me. I recommend them to many people.
Awesome! So glad you enjoy them and thanks for the recommendations!
Thank you for viewing Gsc
Thanks for the class, I just left hospital, I was on scale 7 and basically I'm all purple because doctors tortured me (but I understand why)
Oh wow. So sorry to hear that you have go through this. Hoping that your recovery is going well!
Thank you for the video!
How if the patient only withdraw to pain over the lower limbs and not upper limbs? Will you still consider it as M4? How to assess if patient have one side weakness since their other side cannot not localised pain like Normal patient?
It doesn't matter what side or how many limbs or whatever. You take the best score that you observe. Oftentimes in brain injured patients we will not have symmetry or have dysfunction in what patients are capable of doing. That said, if you can only withdraw from pain on one limb, you are still withdrawing from pain. Make sense?
GCS for intubated patients is 10T, not 11T
Hi, good explanation.
I want to ask you why best motor response is considered only in upper limb not on lower limbs
Thank you. Its not upper over lower, its just the best response that you get you would score that. So if it was lower and that was better than upper, you'd score off the lower.
Really good 👍. Thank you ❤.
Nice and valuable information for medical student also.
Awesome glad to hear you enjoyed it!
Very well explained thank you so much.
Glad to hear it!
4. A 21 year-old male was rushed to emergency room due to road traffic accident. He is gasping for breath and has wound on head and upper extremities, swollen (R) leg, unable to open mouth for bite and raise extremities when asked and complains of severe pain. Based on the scenario, compute the GCS score of the client using the 3 scales.؟
Love you for the great lesson, from India💫💅❤
Super helpful. Thank you!!
Awesome to hear! My pleasure :)
thankyou for such a great video about GCS
Lost me...TBI from surfing and medication dr. Gave me (1997). At least i know what people are talking about now. 20:22
Can a 58 year old person in 4 for 6 days since the day of a car accident after craniotomy recover? Please tell me
Thank you for this!!!
Truly my pleasure Stephanie! Glad you liked it.
Super super helpful.
Thank you @ICUAdvantage
Really great to hear this. You are very welcome Lydiah!
Where does triple flexing of lowers fall into for motor response? Is that worse or better than extension/flexion
Thats spinal reflex and does not score on GCS which is measuring cerebral response
how about patients who has severe tbi injuries who eyes just never close ? still a 4 an E
also how can I tell if something is abnormal posturing or its contractures.. also some contractures does not allow patients to move abnormally to painful stimuli. how do I assess this and document?
E3*
New subscriber here . Thank you Ehdie for informative video
Awesome! Welcome aboard!
Thank you so much it's very useful
Glad it was helpful!
Can 4 out of 15 person can recover?
Excellent video.
Thank you very much!
Thanks dude for this lessons
My pleasure!
Amazing explanation thank you 🙏
Wow, so great to hear this! Thank you!
Thank you so much. Have a nice day :)
Thank you and you too!
What is the GCS of highly intoxicated person?
Don't have enough info to go on. You would basically just score them according to the scale based on what you observe/assess.
please when do you check on these categories for example with the eye opening when will you check for the spontaneous opening eye
I'm not sure I understand your question.
Thanks for you very professional and informative lectures!!!!!
Appreciate that Carlos! Glad you like them.
@@ICUAdvantage thanks is not enough for people like you who cares about saving People's lives and making our jobs easier. It goes a long way! Many, many thanks!
I hope this will help me with my osce
Whats the once?
@@ICUAdvantage the OSCE is a final year nursing physical exam we have to conduct on a "patient" in a simulation here in Australia. We have a patient that deteriorates and one of the scenarios we may get is a patient that becomes confused and declines and we have to recognise this and conduct a full GCS.
THE BEST VIDEO EVER !!!!!! I'm sorry sir but the video has a mistake at 22.09 minutes . E is 3 right?
Glad you liked it. And yeah, I put a correction in the video description. I for some reason wrote 4 while saying 3. 3 is correct. Total score of 9, not 10.
@@ICUAdvantage aww thank you 😊
Thank you
You're welcome
Good understanding
Excellent! 🎯💯
So useful, many thanks
You are welcome!
Good information
Glad you liked it!
Thanks a lot for this great lecture..
Hi, I am enquiring about coma states in view of my cousin's recent medically induced coma at the Heidelberg University Hospital. Thx for such a great video. I got the jist of most of it and understood the clear layman's explanation style. I wonder then, is the GCS relevant only to comas induced naturally? Have I missed anything regarding medically induced comas? If so then would you pls point me in the right direction so my family can have informed discussions with the hospital in the next few days. All the best.
Q - If fine motor muscle movement is lost i.e- Fingers curl and won't straighten or coordinate but abnormal limb flexion/isn't decorticating, would that be considered a M4 please?
If you can't distinguish purposeful movement, but they do withdraw to pain with no posturing present, then yes that'd be a 4.
@@ICUAdvantage Thank you.
I noticed your example was incorrect it should be E3 V2 M4 = 9
Yup. I wrote out one example and then said a different scenario, then read from what I had written.
Very good explanation. Thank you.
Thank you! Glad you enjoyed it!
Thank you for this
You're welcome!
thnk u smch😍u help me alot🙏🙏
How to assess the eyes properly, does the pentorch needs to be direct to the eyes?
We are just assessing if and how they open their eyes. No need for a pen light or to assess pupil size. Just looking at if they will open their eyes, spontaneously, to voice, to pain, or not at all. Thanks for the question!
Great video‼️
Thank you 🤗
VERY INTERESTED GOOD
Glad you liked it!
You are the best!
Thank you!
If a patient is making some growing sounds spontaneously n openingeyes, but sometimes not showing any visual or verbal response to stimulus. Showing some flexor withdrawal to pain full stimulus. And she is on de corticate posture what could be her GCS.
.
A score is a moment in time and especially with brain injury, this will wax and wane. Just score it based on what you assess at that time. If its a big change down, let the providers know in case there is something causing that change that needs to be addressed.
@@ICUAdvantage Than you so much
Good video... Have my OSCE tomorrow so has helped me alot. Only thing as a glaswegian the way you say Glasgow annoys me 😂 sounds like glass-go when you're saying it 😬😂
😬 Yeeeeeah... I'm definitely saying "Glaz-go"
Glad to hear you could overlook my horrible pronunciation and get something useful out of it 😂
Or if they are incubated temporarily. They cannot give a verbal response.
We use the T modifier to signify this.
thank you sir
You're welcome!
Awesome
Ty!
Really helpful! ❤️
I'm so glad!
What if the patient had decerebrate posture on one side. Frown with pain and heart rate increase with external sound but does not respond
As far as the GCS score goes, we'd want to score the highest that we get for a category, so since the posturing is only unilateral, I'd score the higher score that the other side does. The unilateral posturing is typically a localized lesion/edema that is only impacting part of the lower brain.
For the score, grimacing and HR don't play in to it, but can be valuable information as it probably signifies high level response to pain. Is there no eye opening or vocalization?
Hope that helps and thanks for taking the time to ask the question!
@@ICUAdvantage no eye opening no vocalization brain injury is hemmoraghic stroke to ventricles
So both for E an V you'd score a 1. The question would be on the side that isn't posturing, whats the best they are doing? Withdrawing to pain?
@@ICUAdvantage I'm sorry, let me explain in detail. He had hemmorage in his brain in his third and fourth ventricle. He displayed mild decerebrate posture in both arms. His heart rate would increase upon hearing certain voices and if you moved him around he would frown. He showed mild flexion. If you scratched his feet he would move a little. Slight Gag reflux was present. He could take some breaths on his own but need ventilators. If ventilator was removed he have rapid breathing. They couldn't remove the hematoma with the drainage catheter and refused to do surgery. In this case is there any hope
No eye opening and no vocalization no meaningful movement other than twitching.
O'Conner Turnpike
Thank you!
Dear my brother and Sister my czn is get accident and right now he is in 7/15 plz guys tell me its possible they can recover ... plz i am waiting for your guys reply thanks . Alot
How is he now?
@@mohammadkhizar6674 no more bro ...
Oh so sad... my czn is in coma frm 3 months
Thanks ♥️♥️♥️♥️♥️
You're very welcome!
Good
Thanks
What about the patient? opens his eyes but can recognise me.
The score would be lower on speech because they wouldn't recognise you I suppose
example of GCS total was 9 not 10 i think
Yeah, see the note in the video description
Intubated patient max score is 10 u said it's 11why so
E4 V1 M6, you still get a pt for verbal (no zeros) :)
❤❤❤❤❤❤
TY! ❤
I don't understand. How are you getting dislikes? Do they not like the colors? The detailed information? Or did they suffer from "mouse pad malfunctions"? LOL
Hahah DUDE I know!? I've always wondered. I've convinced myself they meant to hit the like and just didn't notice it was the dislike lol
😎
G
you have too many adds on your video
They are just set for UA-cam to add them in automatically
ICU Advantage literally every 5 mins there’s an add. Most I’ve ever seen on one video