![]() ![]() Ideally, use an interpreter if the patient does not speak English.Ascertain the patient’s acuity of hearing.Painful stimuli that can elicit this response include trapezium squeeze (Fig 4), suborbital ridge pressure (Fig 5) (not recommended if there is a suspected/confirmed facial fracture) and sternal rub (caution, not recommended in some organisations) (Fig 6) (Jevon, 2007). ![]() Score 1: no response to painful stimuli.Ī true localising response to pain involves the patient bringing an arm up to chin level.The patient extends the arm by straightening the elbow and may be associated with internal shoulder and wrist rotation The patient flexes or bends the arm characterised by internal rotation and adduction of the shoulder and flexion of the elbow, much slower than normal flexion The patient flexes or bends the arm towards the source of the pain but fails to locate the source of the pain (no wrist rotation) The patient does not respond to a verbal stimulus but purposely moves an arm to remove the cause of a central painful stimulus The patient can perform two different movements Record ‘D’ if the patient is dysphasic and ‘T’ if the patient has a tracheal or tracheostomy tube in situ.Īssessment of motor response is designed to determine the patient’s ability to obey a command and to localise, and to withdraw or assume abnormal body positions, in response to a painful stimulus (Adam and Osborne, 2005):.This is despite both verbal and physical stimuli. Record ‘C’ if the patient is unable to open her or his eyes because of swelling, ptosis (drooping of the upper eye lid) or a dressing.Īssessment involves evaluating awareness:.Score 1: eyes do not open to verbal or painful stimuli.Score 2: eyes open in response to pain only, for example trapezium squeeze (caution if applying a painful stimulus).Assessment of eye opening involves the evaluation of arousal (being aware of the environment): ![]()
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