mkvtkm tima kvsibnâ þ aebmf ]cn`mj

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1 ISNACC TRAINING PROGRAM sf.fkv.f³.f.kn.kn. ]cnioe\ ]cn]msn Glasgow Coma Scale : English Malayalam Version mkvtkm tima kvsibnâ þ aebmf ]cn`mj ISNACC Training Program 1

2 Glasgow Coma Scale : Malayalam Translation mkvtkm tima ØíæµÏßW : aebmf ]cn`mj ISNACC Training Program 2

3 What all we will learn \½Ä Fs Ãmw ]Tnçw 1. What is GCS? 2. What are its components? 3. How do we assess each component? 4. When is GCS used? 1. F mwv Pn.kn.Fkv? 2. Fs ÃmamWv CXnsâ LSI Ä? 3. F s\bmwv \½Ä CXnsâ Hmtcm LSIhpw \nà bnç Xv? 4. Ft mgmwv Pn.kn.Fkv. D]tbmKnç Xv? ISNACC Training Program 3

4 Glasgow Coma Scale (G C S): mkvtkm tima ØíæµÏßW (Pn.kn.Fkv): GCS is a neurological scale It provides an objective way of recording the conscious state of a person It can be used for initial assessment as well as subsequent assessment Pn.kn.Fkv. F Xv \munhyhøbpss {]hà \s Af mëå Hê am\zþamwv. Hê hyànbpss t_m[mhøsb ædn på hkvxp\njvtamb Hê Nn{Xw CXp \Âæì. {]myani hnebnê enëw XpSÀ hnebnê enëw CXp D]tbmKn mhp XmWv. ISNACC Training Program 4

5 Glasgow Coma Scale (G C S): mkvtkm tima ØíæµÏßW (Pn.kn.Fkv): The scale was published in 1974 by Graham Teasdale & Bryan J. Jennett, Professors of Neurosurgery University of Glasgow þâ mkvtkm kàhiemimebnse \ tdm kàpdn hn`mkw {]^kàamcmb {Klmw SokvtUÂ, {_bm³.sp.sp äv F nhcmwv Cu kvsibenëv cq]w \ÂInbXv ISNACC Training Program 5

6 Elements of G C S: Pn.kn.Fknsâ LSI Ä: G C S is composed of three components : Eye response Verbal response Motor response Each of these components further have scores Pn.kn.Fknëv aq v LSI fméåxv : t\{x- {]XnIcWw --- i_vz {]XnIcWw Ne\ {]XnIcWw Cu Hmtcm LSI nëw \nýnxamb kvtimdpiä \ÂIs «ncnçì Let s see what are the sub-components Cu Hmtcm LSIhpw F mwv F vv \apç ]cntim[n mw- ISNACC Training Program 6

7 Eye response (E) : 4 score t\{x {]XnIcWw (C): 4 kvtimà There are four points. Starting with the best to the most severe, they are: Eyes opening spontaneously (4 points) Eye opening to speech (3 points) Eye opening in response to pain stimulus (2 points) No eye opening (1 point) H v apxâ \mep hscbmwv CXnsâ t]mbnâpiä. Cu t]mbnâpiä hftc \ÃXnÂ XpS n Gähpw Xo{hambXnsâ ASnØm\ nemwv {Ias Sp nbncnç Xp. kzbta I piä Xpdçì (4 t]mbnâkvvv) Õß{ßAáçOÞZ µháµz ÄáùAáKá (3 t]mbnâkvv) çõæè ÈWµáçOÞZ µháµz ÄáùAáKá (2 t]mbnâkvv) µháµz ÄáùAáKçÄÏßÜï (1 t]mbnâ v) ISNACC Training Program 7

8 How we check Eye Response to pain çõæè ÈWµáçOÞZ U t\{x {]XnIcWw BæÈ ÉøßçÖÞÇßAÞ Pain stimulus : çõæè ÈWµáKÄßÈáU ÎÞVPBZ : 1. Nail bed pressure 2. Interdigital pressure 3. Supraorbital Pressure 4. Sternal Rub (See next slide for demonstration) 1. È Jßæa ºáÕGßW ÎVJáµ 2. ÕßøÜáµÜáæ ÏßW çéèçïþ æéxøßçüþ æõºîí çºvjí ÎVJáµ. 3. µyéáøßµjßèá Îáµ{ßÜÞÏß ÎVJáµ 4. s\ nsâ ÎáX ÍÞ JÞÏß ÎVJáµ (æºçïîi ÕßÇ áj èøïáßw µþãþõákäþãí ) Caution : Painful stimulation should be minimal needed to elicit the response. döißçaiäí: déäßµøã {ÕÞAáKÄßÈáU xõá ºáøáBßÏ çõæè am{xta ÈWµÞÕâ ISNACC Training Program 8

$t\{x {]XnIcWw BæÈ ÉøßçÖÞÇßAÞ :$ ºßdÄBZ Nail bed pressure È Jßæa

$Sternal Rub s\ nsâ ÎáX ÍÞ JÞÏß ÎVJáµ$

9 How we check Eye Response : pictures t\{x {]XnIcWw BæÈ ÉøßçÖÞÇßAÞ : ºßdÄBZ Nail bed pressure È Jßæa ºáÕGßW ÎVJáµ Interdigital pressure ÕßøÜáµÜáæ ÏßW çéèçïþ æéxøßçüþ æõºîí çºvjí ÎVJáµ. Sternal Rub s\ nsâ ÎáX ÍÞ JÞÏß ÎVJáµ Supraorbital Pressure µyéáøßµjßèá Îáµ{ßÜÞÏß ÎVJáµ ISNACC Training Program 9

10 Verbal response (V): 5 scores i_vz {]XnIcWw(hn) :5 kvtimàkv There are five points. Starting with the best to the most severe, They are: Oriented (5points) Confused (4 points) Inappropriate speech (3 points) Incomprehensible speech (2 points) None (1 points) H v apxâ A v hscbmwv CXnsâ t]mbnâpiä. Cu t]mbnâpiä hftc \ÃXnÂ XpS n Gähpw Xo{hambXnsâ ASnØm\ nemwv {Ias Sp nbncnç Xp. ]pà ambpw kzm`mhniamb kwkmcw (5 t]mbnâkvv) Aåw ægª kwkmcw (4 t]mbnâkvv) ]ckv]c _ÔanÃmsXbpÅ kwkmcw (3 t]mbnâkvv) XoÀ pw a\ênem m³ Ignbm kwkmcw. (2 t]mbnâkvv) Hê iðhpw ]pds Sphn m AhØ (1 t]mbnâ v) ISNACC Training Program 10

11 Motor response (M): 6 scores Ne\ {]XnIcWw(Fw): 6 kvtimàkv There are six points. Starting with the best to the most severe, they are: Obeying commands (6 points) Localizing response to pain (5 points) Withdraws to pain (4points) Abnormal flexor response (3 points) (See next slide) Extensor posturing to pain (2 points) (See next slide) No response to pain (1 point) H v apxâ Bdp hscbmwv CXnsâ t]mbnâpiä. Cu t]mbnâpiä hftc \ÃXnÂ XpS n Gähpw Xo{hambXnsâ ASnØm\ nemwv {Ias Sp nbncnç Xp. \nàt±i Ä IrXyambn Aëkcnçì (6 t]mbnâkvv) thz\ \Âæ Øew Xncn dnbpì. (5 t]mbnâkvv) thz\ \Âæ Øew ]n³hençì (4 t]mbnâkvv) Akm[mcWamb coxnbnepå ssi/imâ as Â. (3 t]mbnâkvv) ( áj èøïáßw IméI) Akm[mcWamb coxnbnepå ssi/imâ \nhà Â (2 t]mbnâkvv) ( áj èøïáßw IméI) thz\tbmsv bmsxmê {]XnIcWhpanÃm AhØ (1 t]mbnâ v) ISNACC Training Program 11

$Posture : icoc nsâ AhØ: Extension Posturing Akm[mcWamb coxnbnepå ssi/imâ \nhà Â.$

12 Posture : icoc nsâ AhØ: Extension Posturing Akm[mcWamb coxnbnepå ssi/imâ \nhà Â. Abnormal Flexion Akm[mcWamb coxnbnepå ssi/imâ as Â. ISNACC Training Program 12

13 Maximum & Minimum GCS Scores IqSnbXpw ædªxpamb Pn.kn.Fkv. kvtimàkv Maximum score : E4V5M6 : 15 (Fully conscious patient) Minimum score : E1V1M1 : 3 (Deeply comatosed ) Gähpw IqSnb kvtimà: (C)4 (hn)5 (Fw)6: 15 (]qà t_m[mhø) Gähpw ædª kvtimà (C)1 (hn)1 (Fw)1: 3 (]qà At_m[mhØ) ISNACC Training Program 13

14 When is GCS used? Ft mgmwv Pn.kn.Fkv. D]tbmKnç Xv? Traumatic Brain Injury Poisoning As part of ICU scoring system akvxnjvi në XtaähÀ. hnjw DÅnÂ sn hà. Xo{h]cnNcW hn`mk nse tcmkniä mbn DÅ kvtimdn v kwhn[m\ nsâ `mkambn«v. ISNACC Training Program 14

15 Why is GCS important? F mwv Pn.kn.Fknsâ {]m[m\yw? It informs about the prognosis of the patient. Fall in GCS means deterioration Rise in GCS means improvement tcmk hnapànbpss km[yxiä Xncn dnbm³ klmbnçì. kvtimà ædbp Xp tcmkn tamiamæ Xnsâ kqn\ifmwv. kvtimà IqSp Xp tcmkn sa s Sp Xnsâbpw ISNACC Training Program 15

$D]tbmKn v tcmk Xo{hX \nà bnç$ Xo{hX MODERATE : 9-12 CS cw

16 Severity assessment by GCS Pn.kn.Fkv. D]tbmKn v tcmk Xo{hX \nà bnç coxn. SEVERE : 3-8 IqSnb Xo{hX MODERATE : 9-12 CS cw Xo{hX MILD sndnb Xo{hX ISNACC Training Program 16

17 How often one should check for G C S? Ft msgãmamwv tcmknbpss Pn.kn.Fkv. ÈßVHÏßçAIÄí? Immediately on admission. Subsequent assessment depends upon the seriousness of the patient More serious, assess more frequently Bip]{XnbnÂ AUvanämbpSs\ XpSÀ \nà bw tcmkxo{hxsb B{ibn ncnçì AXoh - KpêXcmhØbnepÅhÀç IqsS IqsS çèþçaiäþãí. ISNACC Training Program 17

18 Glasgow Coma Scale : English-Malayalam Translation mkvtkm tima kvsibnâ þ aebmf ]cn`mj Compiled for ISNACC Translation team : Dr. Varun.S. Dr. Priya.P. sf.fkv.f³.f.kn.knþç çõiß X mdm nbxv tum. hê.fkv. tum. {]nb. ]n. For feedback and information visit website : www. isnacc.org Contact isnaccsecretariat@yahoo.in ISNACC Training Program 18

ISNACC TRAINING PROGRAM

ISNACC TRAINING PROGRAM ISNACC тштт ткттткт тт Glasgow Coma Scale : English - Telugu Version т т ткт тткт тåт т -ттт тaтттт ISNACC Training Program 1 Glasgow Coma Scale :Telugu translation т т ткт тткт: