Excepcionalmente, se han descrito casos de acidosis metabólica y coma que .. aguda por salicílicos era especialmente frecuente en pediatría en la década de .. del pH gástrico e intestinal, del pK del barbitúrico y del grado de solubilidad. Glasgow Coma Scale at 40 | The new approach to Glasgow Coma Scale assessment . excepto en la hipoglucemia, hiponatremia, encefalopatía hepática e intoxicación barbitúrico. .. Escala de Coma de Glasgow (Adaptada a Pediatría). CRISIS CONVULSIVAS EN PEDIATRIA DEFINICION CONVULSION = Alteración de la fución neuronal. Descarga paroxística anormal de la.

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Escala de Coma de Glasgow.

Tricoflos – Wikipedia

Jennett y el Dr. Escala de Coma de Glasgow Actualizada. Escalas oculares y verbales. Registro de la Escala de Coma de Glasgow. Se recomienda que los hallazgos en serie se documenten en una tabla de escala de coma. Table created by Bryan Young. Mirada hacia la nariz: En pacientes con coma: Si ambas son normales: Ausencia de respuesta unilateral o bilateral: Tendremos que tener en cuenta el ABC y la causa del coma.

Se define como estado de tetraplejia y anartria imposibilidad para articular palabra con estado de conciencia y funciones cerebrales conservadas.

En resumen el paciente presenta: Validity of the FOUR score coma scale in the medical intensive care unit. Clinical scales for comatose patients: G Bryan Young, MD. Stupor and coma in adults. Hace unos meses me puse en contacto con los responsables del proyecto, que se mostraron encantados de que les enviara el texto de la hoja traducida.

Se incluyeron pdeiatria pacientes de trauma que concurrieron al departamento de emergencias en ambulancia, desde julio hasta junio del The paper can be accessed and downloaded for free from here, where you can read about the development of the GCS-P in more detail. A summary of the background to its development can also be read at the end of this article llnk to section below.

Further information on assessment of the GCS can be accessed here. The Pupil Reactivity Score is calculated as follows.

So, imagine that you are asked to assess a patient who has been ejected from the passenger seat of a car at high velocity. They make no eye, verbal or motor movements spontaneously, or in response to your spoken requests.

When stimulated their eyes do not open, they make only incomprehensible sounds, and their arms abnormally flex.

You now test their pupil reactivity to light. Neither pupil is reactive to light. What is the advantage of the GCS-P? Separately, the GCS and the pupil response to light are both related to outcome. As you can see from the above example, combining the information cpma in the GCS-P extends the information provided about outcome to an extent comparable to more complex methods of combination of the data.


This may improve decision making about patient care, and assist in stratification of patients into clinical trials. The work underpinning the GCS-P was published by the Journal of Neurosurgery pedaitria April as one of two joint papers from our group that sought to simplify the use of prognostic information in traumatic brain injury. The second paper describes a graphical presentation of the outcome probabilities in traumatic brain injury.

These trade off a loss of detail and specificity of information with the ease and transparency of the calculation of the score. Each of the three components of the Glasgow Coma Scale Eyes, Verbal, Motor contains information about prognosis and the findings can be combined in a summary total score, derived from simple addition of a notation assigned to its components.

There have nevertheless been views that more complex scores, with extra features would be useful. The GCS together with information about pupil reaction conveys barbihurico of the clinical predictive information in head injured patients. We, therefore, have investigated different ways of combining the information from these two key features peditria an index of prognosis, either mortality or unfavourable outcome vegetative or severe disabilityin acute head injured patients.

The charts provide a simple graphical presentation of the probabilities of outcome from traumatic brain injury based on GCS, pupil reactivity, age and CT scan findings. A reason may be that clinicians are uneasy about dealing with explicit mathematical probabilities, especially if the process of producing them seems opaque.

Whatever the reasons limiting uptake, clinical care itself is exposed to the influence of personal, highly variable subjective opinions, and more effective and acceptable methods of communicating prognosis are needed. Understanding risks through graphical aids may provide a simpler assessment of risk than more complicated models. Four prognostic factors contain much of the information about prognosis of people with an acute head injury; GCS, pupil reactivity to light, age, and the findings on Computer Tomography CT scan are the most useful investigative index.

We therefore investigated ways of combining them to convey information graphically about risks of mortality, or the prospects for independent recovery, after head injury. We aimed to develop a method of displaying probabilities graphically pediattria would be simple and easy to use, so improving the usefulness of prognostic information in neurotrauma.

The chart above is one chart from the group of three that is used to estimate 6 month mortality. We will explore in barbbiturico moment why pediatriz are three charts for each outcome. So, imagine that you are asked to assess a 50 year old patient who has been ejected from the passenger seat of a car at high velocity.


The estimate of 6 month mortality can then be ascertained by consulting bxrbiturico chart: In addition to GCS, pupil reactivity and age, CT findings are the other important predictor of patient outcome. We demonstrated in doma paper that analysis of CT scan findings showed the differences in outcome are very similar between patients with or without either a haematoma, or absent cisterns, or subarachnoid haemorrhage.

Pediarria in combination there is a gradation in risk with pediatrla numbers of any of these abnormalities. A simple extension of the prognostic charts can then be made by stratifying the original charts into three CT groupings: How do I read the result for a patient who is 55 years old?

This should be read as half way between the 50 and 60 year old age cut offs. How do I differentiate big and small haematomas? These studies include patients exhibiting a wide spectrum of haematoma.


As such, for these tables, the size of the haematoma or severity of subarachnoid haemorrhage does not need to be separately considered; the size and severity will influence the GCS and pupil reactivity.

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Cirugia Menor Heridas Suturas http: Grupo de Cirugia Menor y Dermatologia. Societat Valenciana de Medicina Familiar i Comunitaria http: Protocolo de Atencion para Cirugia. Ministerio de Salud Publica Rep. Dominicana Hacemos entrega del Sistema Completo eeiispain gmail. Medical Doctor for complex and high-risk missions.


IberoAmericana de Emergencias https: Registro pediattria la Escala de Coma de Glasgow Se recomienda que los hallazgos en serie se documenten en una tabla de escala de coma. A la voz 3. Apertura ocular pero no focalizada. Respuesta extensora al dolor. Respuesta flexora al dolor. Reflejos del tronco cerebral. Reflejos pupilares, corneales o de tos ausentes.

Reflejos pupilares y corneales ausentes. Reflejos pupilares o corneales ausentes. Reflejos pupilares y corneales presentes. Barbituricoo motora al estimulo doloroso. Escala Modificada de Coma de Glasgow. Glasgow de 8 o menos.