Acute Neurological Impairment
Mr. N’s story:
Mr. N. sustained a traumatic brain injury. He is 46 years old and was riding his motorcycle without a helmet when he crashed.
He was airlifted to the hospital and on arrival had a GCS of 13.
He was subsequently intubated because of a deteriorating GCS and symptoms of Cushing’s triad.
He was immediately shifted to the operating room where he was seen by multiple specialists.
Come prepared for tutorial 3 by answering the following questions:
Questions:
1. The most important neurological assessment you can do is a Glasgow Coma Scale (GCS). What are the three (3) neurological responses assessed when assessing GCS (1.5 marks)
2. What is the lowest GCS and what is the highest GCS? (1 mark)
3. Which GCS score indicates severe impairment and inability to maintain airway (0.5 mark)
4. At what point should you report a change in GCS (1 mark)
5. When assessing Mr. N’s GCS, describe how you would assess eye response, verbal response and motor response (3 marks – maximum of 1 mark per response)
6. When completing your neurological assessment, what other assessments (besides GCS) are recorded on the neurological observation chart (1.5 marks)
7. When you walk into the room to perform neurological observations on Margaret, she is fast asleep. Should you wake her to do your obs or should you allow her to sleep to rest her brain?
8. What acute neurological impairment is known to reduce GCS score? (1 mark)
9. What signs and symptoms indicate Cushing’s Triad? (2 marks)
10. What does Cushing’s Triad indicate? (1 mark)
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