Glasgow

dr. Ronald Coma

Scale
dr. Ghina Aghniya
dr. Sheila Sumargo
dr. Mochamad Akbar Azizi
dr. Dedy Oskar
dr. Randhi Rinaldi
dr. Rafika Aninda
drg. Erza Kurniawan
drg. Niken Laksmitarina
 Level Kesadaran dan
Status Neurologis

• Kesadaran adalah indikator yang paling sensitif dari perubahan neurologis dan hal
yang pertama diperhatikan pada tanda-tanda neurologis
• Status awareness pada diri sendiri dan lingkungan, termasuk kemampuan untuk
berorientasi terdapat stimulus baru
• Hal ini karena aktivitas structural saraf yang terintegrasi, yang melibatkan reticular
formation dan interaksi dengan cerebral cortex
 Level Kesadaran dan
Status Neurologis

 Ada 3 komponen pada kesadaran yang diperngaruhi oleh suatu proses penyakit,
diantaranya :
 Arousal or wakefulness (contoh : membuka mata saat
diperintahkan)
 Alertnessand awareness (contoh : orientasi dan
komunikasi)
 Appropriate voluntary motor activity (contoh : menjalankan
perintah)
 Pelayanan Emergensi

Disability :
Airway Breathing Circulation Status Exposure
Neurologis

(American College of Surgeons Committee 2004)

 Level kesadaran dan
status neurologis

Common methods of assessing conscious level are:

AVPU
GCS

 Both are potential tools for assessing the conscious level, and either can be
used in the Early Warning Score (EWS) system used in many hospitals.
 AVPU

A – Alert Responds spontaneously

V – Verbal Responds to voice

P – Pain Responds to pain stimuli

U - Unresponsive No response to verbal or pain stimuli

Glasgow Coma Scale
This is an
example of a
neurological
assessment chart
When
documenting
observations on
the neurological
assessment chart,
it is important to:
1. Complete all
sections.
2. Use dots not
ticks! The chart
demonstrates the
patients graphical
trends over time.
 Glasgow Coma Scale (G.C.S.)

 The GCS:
• Is a simple & standardised system to detect changes in level of consciousness
• Should be quick, easy, objective & accurate if people have been trained to use it
correctly
• Is used internationally
• Is designed to reduce observer variability and has a high degree of inter-rater
reliability
 Rowley & Fielding 1991, Harrahill 1996, Fairley & Cosgrove 1999, Heron
et al 2001, Teasdale 2004
• The GCS tool provides a common language for communication between multi-
disciplinary groups.
 (Hickey 2003)

• It is an important assessment tool. Care should be taken when delegating this

assessment to ensure individual competency to perform the procedure

• GCS is applicable for paediatrics as well as adults, and has been adapted for use
in in this area
 Glasgow Coma Scale (G.C.S.)

 Patients in any clinical setting may require assessment of conscious level for a
number of reasons:
 Hypoxia
 Metabolic imbalance such as hypoglycaemia
 Falls and trauma to the head
 Unresponsiveness
 Neurological disease processes e.g. stroke, brain tumours,
epilepsy
 Post-anaesthesia
 New admissions to form a baseline assessment
An example of the Glasgow Coma Scale (G.C.S.)
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