Disadvantages of sedating neurologic patient

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The GCS is determined by assessing three aspects: eye opening (four levels), verbal response (five levels) and motor response (six levels).The best response is taken and a sum of all three elements is decided.Thus, it needs to be distinguished from the following terms: The GCS is used across the world and is a means of scoring a patient's conscious level.It is also useful to monitor progress of the patient.Classification and diagnosis can be difficult and require expert repeated multidisciplinary neurological/neurosurgical assessment and input of family, friends and carers to be sure of the state in a given patient.It is thought that misdiagnosis is a common problem.The patient is unresponsive and cannot be roused.'It may be a transient phenomenon during acute illness or persist in the long term.

However, there are some disadvantages to using the AVPU scale: Priority has to be to resuscitate the patient first, as mentioned above.

Is this the predictable progression of an existing disease - eg, brainstem infarction, intracranial mass lesions, subarachnoid haemorrhage?

Alternatively, is this an unpredictable event associated with a pre-existing disease - eg, cardiac arrhythmia, systemic sepsis?

This depends on the underlying cause and upon the depth, duration and which clinical signs are present.

However, if the cause is a head injury then prognosis is directly proportional to the GCS score, ie those with a score less than 8 having a very poor prognosis.

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