ARCHETYPE Paediatric Glasgow Coma Scale (openEHR-EHR-OBSERVATION.glasgow_coma-paed.v1)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.glasgow_coma-paed.v1
ConceptPaediatric Glasgow Coma Scale
DescriptionFifteen point scale used to assess the level of consciousness of a child subject. Also known as the Modified Glasgow Coma Scale for Infants and Children.
UseUse in any clinical situation to assess the level of consciousness of a subject, with the exception of infants and young children. The three response values are considered separately as well as their sum. The minimum possible Total score value is 3 and the maximum possible is 15. The Total score can be derived as the sum of the recorded scores for each of the eye, motor and verbal responses. The EMV score can be derived as a composite from each of the recorded response scores, for example E3 M2 V4 represents the conscious state of a subject who opens eyes to speech, has an extensor response to pain and utters incomprehensible sounds. If any one of the eye, motor or verbal responses cannot be assessed - for example if the subject is intubated and not able to respond verbally, or paralysed and not able to provide a motor response - the score recorded for the response is 1 and a modifier attached. If the subject is intubated the verbal response component can be represented as V1t, where t = tube, or V1Intubated. If the subject has severe facial/eye swelling or injuries and can't open their eyes, the eye response component can be represented as E1c, where c=closed. Often the numeric one is omitted, so the eye response component can be expressed more simply as Ec, for example Ec M2 V4. Clinical Decision support should be based upon each of the specific records of eye, motor and verbal responses and the explicit statements that a response cannot be assessed, rather than the derived and composite EMV score.
MisuseNot to be used for assessing adults- use the OBSERVATION.glasgow_coma.v1.adl to ensure that the eye, motor and verbal response choices are appropriate.
PurposeTo record clinical observations regarding responsiveness of a subject to stimuli as an objective assessment of the conscious state of a child subject. Also known as JGCS (James' GCS).
ReferencesDerived from: https://ckm.openehr.org/ckm/#showArchetype_1013.1.1947
Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974,2:81-84.

Teasdale GM, Murray L. Revisiting the Glasgow Coma Scale and Coma Score. Intensive Care Medicine. 2000; 26: 153-154.

Worrall K. Use of the Glasgow coma scale in infants. Paediatric nursing 2004;16(4):45-50.

Tatman A, Warren A, Williams A, Powell JE, Whitehouse W. Development of a modified paediatric coma scale in intensive care clinical practice. Archives of disease in childhood 1997;77(6):519.
Copyright© copyright (c) 2010 openEHR Foundation, HiGHmed
AuthorsAuthor name: Heather Leslie
Organisation: Ocean Informatics
Email: heather.leslie@oceaninformatics.com
Date originally authored: 2007-13-03
Other Details LanguageAuthor name: Heather Leslie
Organisation: Ocean Informatics
Email: heather.leslie@oceaninformatics.com
Date originally authored: 2007-13-03
OtherDetails Language Independent{custodian_organisation=HiGHmed, references=Derived from: https://ckm.openehr.org/ckm/#showArchetype_1013.1.1947 Teasdale G, Jennett B. Assessment of coma and impaired consciousness. A practical scale. Lancet 1974,2:81-84. Teasdale GM, Murray L. Revisiting the Glasgow Coma Scale and Coma Score. Intensive Care Medicine. 2000; 26: 153-154. Worrall K. Use of the Glasgow coma scale in infants. Paediatric nursing 2004;16(4):45-50. Tatman A, Warren A, Williams A, Powell JE, Whitehouse W. Development of a modified paediatric coma scale in intensive care clinical practice. Archives of disease in childhood 1997;77(6):519., original_namespace=org.highmed, original_publisher=HiGHmed, custodian_namespace=org.highmed, MD5-CAM-1.0.1=A93D8F14A2304FA5D3467C225EF45CCC, build_uid=09cb6106-9824-40f4-a926-dbe23e85dc32, revision=1.0.0}
Keywordsresponse, motor, verbal, eye, stimulus, glasgow, coma, scale, neurological, responsiveness, EMV, conscious, paediatric, JGCS
Lifecyclepublished
UID1b2b5dbe-4029-4832-9584-c7048ad003a7
Language useden
Citeable Identifier1246.145.679
Revision Number1.0.0
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6: Obeys commands [Follows simple verbal commands.]
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6: Moves spontaneously [Moves spontaneously and purposefully.]
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5: Oriented [Converses, oriented to their environment.]
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5: Normal spontaneous facial/oro-motor activity [Spontaneous normal facial/oromotor activity.]
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6: Obeys commands [Follows simple verbal commands.]
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6: Moves spontaneously [Moves spontaneously and purposefully.]
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3: Inappropriate speech [Intelligible speech, but no conversational exchange.]
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5: Oriented [Converses, oriented to their environment.]
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2: Incomprehensible words or nonspecific sounds [Moans or groans, but no recognisable words.]
3: Inappropriate words [Intelligible speech, but inappropriate words.]
4: Confused [Converses, but confused and disoriented in their environment.]
5: Oriented, appropriate [Converses, oriented to their environment.]
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3: Cries [Cries inappropriately.]
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5: Coos and babbles [The infant is alert babbles, coos or says words or sentences to their usual ability.]
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2: Mild grimace [Mild grimace or some change in facial expression to pain.]
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4: Less than usual spontaneous activity [Less than usual spontaneous ability or only responds to touch.]
5: Normal spontaneous facial/oro-motor activity [Spontaneous normal facial/oromotor activity.]
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