How to assess the level of consciousness during a first aid procedure

The evaluation of level of consciousness is one of the first things that must be done when providing first aid to a person who has suffered trauma or an accident. The level of consciousness can provide important information about the person's condition and the severity of the incident.

In general, the level of consciousness refers to the degree of awareness and attention of the person towards the surrounding environment. There are different ways to assess the level of consciousness, but the Glasgow Coma Scale (GCS) is one of the most common methods used by healthcare professionals.

The Glasgow Coma Scale

The Glasgow Coma Scale was developed in the 1970s by Graham Teasdale and Bryan Jennett at the University of Glasgow and has since been adopted worldwide as one of the main tools for assessing level of consciousness. The scale evaluates three aspects: eye opening, verbal response, and motor response.

• Eye opening: This parameter measures a person's ability to open their eyes. It can range from "does not open eyes" to "opens eyes spontaneously".
• Verbal response: This parameter measures a person's ability to communicate verbally. It can range from "no sounds" to "responds appropriately and coherently".
• Motor response: This parameter measures a person's ability to respond to motor commands. It can range from "no response" to "responds appropriately and coordinated".

Based on scores obtained in each of the three categories, overall level of consciousness can be assessed. The maximum score is 15, which indicates normal level of consciousness.

The Glasgow Coma Scale is a useful tool for quickly assessing a person's level of consciousness during first aid. However, it is important to note that this scale does not provide complete information about the person's condition and the severity of the incident. Therefore, it should be used in conjunction with other assessment and diagnostic techniques.

The level of consciousness evaluation scale: GCS

The most commonly used scale for evaluating level of consciousness in healthcare is the Glasgow Coma Scale (GCS). This scale is used to assess the degree of impairment of brain function following head trauma or other conditions that can cause alterations in consciousness.

How does the GCS scale work?

The GCS scale involves the evaluation of three parameters:

• Eye opening: The degree of eye opening is evaluated, which can range from "does not open eyes" to "opens eyes spontaneously".
• Verbal response: The patient's ability to respond verbally to external stimuli is evaluated. Again, scores can range from "no verbal response" to "appropriate and coherent response".
• Motor response: The patient's ability to move limbs in response to external stimuli is evaluated. Scores can range from No motor response to Appropriate and coherent response".

Based on the results obtained, the patient is assigned a score ranging from 3 to 15. A low score indicates severe impairment of brain function, while a high score indicates less impairment.

Example of using the GCS scale

Suppose we are faced with a patient who does not respond to external stimuli and does not open their eyes. In this case, the score for eye opening and verbal response would be 1 out of 4 (the maximum possible score is 4). If the patient does not even respond to painful stimulation, the score for motor response would be 1 out of 6 (the maximum possible score is 6).

By adding up the three scores obtained, we would have a total score of 3 out of 15. This result indicates severe impairment of the patient's brain functions and requires immediate intervention by healthcare personnel.

How to use the GCS scale to assess level of consciousness

The Glasgow Coma Scale (GCS) is a tool used by emergency responders and doctors to assess a person's level of consciousness. The scale is used in emergency situations such as head trauma or stroke.

How the GCS scale works

The GCS scale evaluates three parameters: eye opening, verbal response, and motor response. Each parameter is assigned a score from 1 to 5 or from 1 to 6. The maximum score obtainable is 15.

• Eye opening: This parameter evaluates whether the person has closed eyes (score 1), opens them in response to voice (score 3), or opens them spontaneously (score 4).
• Verbal response: This parameter evaluates whether the person does not make any sounds (score 1), makes sounds but does not speak (score 2), speaks with incomprehensible words (score 3), speaks with understandable but confused words (score 4) or speaks appropriately (score 5).
• Motor response: This parameter evaluates whether the person shows no reaction (score 1), only presents reflex movements (score 2), presents movements in response to painful stimulus (score 3), presents movements in response to verbal stimulus (score 4) or presents spontaneous and appropriate movements (score 6).

The total score obtained by adding up the three parameters indicates the person's level of consciousness. A low score may indicate severe brain injury or respiratory failure, while a high score indicates that the person is alert and conscious.

Example of using the GCS scale

Let's imagine we are faced with a person who has suffered head trauma. The first step is to check if the person has their eyes open or closed. If their eyes are closed, try to open them with a loud voice or gently touching their face.

Once the person has opened their eyes, evaluate their verbal response. Simple questions can be asked to verify if the person is able to speak and understand words. For example, you can ask the person what their name is or where they are.

Finally, the person's motor response must be evaluated. You can try to stimulate the person's muscles by moving their arms or legs. If the person does not react, you can try to stimulate them with a painful stimulus, such as pinching the skin or pressing on the nails.

By adding up the scores obtained from the three parameters, you can determine the person's level of consciousness and act accordingly to provide the appropriate medical treatment.

What to do in case of low level of consciousness: actions to take immediately

If during the evaluation of the level of consciousness of the person a low level is found, it is important to act quickly to save the person's life. Here are some actions to take immediately:

1. Call 118

The first thing to do is to immediately call the emergency number 118 and provide them with all necessary information about the situation, such as the exact address of the incident, the name of the person involved and a detailed description of their condition.

2. Place the person in a lateral safety position

If the person is not breathing or having difficulty doing so, it is necessary to place them in a lateral safety position (LSP). This position allows the tongue to fall forward, preventing it from obstructing the airway. This also facilitates drainage of bronchial secretions and prevents any vomit from entering the lungs.

3. Perform CPR

If the person is not breathing, it is necessary to perform cardiopulmonary resuscitation (CPR) until the arrival of emergency services. CPR involves combining mouth-to-mouth breathing with chest compressions. This helps to maintain the flow of oxygen to the brain and vital tissues of the body, increasing the chances of saving the person's life.

4. Constantly monitor the person

Throughout the rescue process, it is important to constantly monitor the person to check for any changes in their condition. In case of deterioration, it is necessary to act immediately and communicate it to medical personnel when they arrive on site.

5. Provide emotional support

In emergency situations like this, it is common for the person involved to feel scared and panicked. It is important to provide emotional support to the person, reassuring them and trying to keep them calm until emergency services arrive.

• To sum up, in case of low level of consciousness:
• Call the emergency number 118 immediately;
• Place the person in a lateral safety position;
• Perform CPR;
• Constantly monitor the person;
• Provide emotional support.

Conclusions and final recommendations for evaluating the level of consciousness during a first aid procedure

In conclusion, assessment of the level of consciousness is a fundamental step in a first aid procedure. It allows for timely identification of any neurological problems or brain injuries that could endanger the life of the person being assisted.

To perform a correct assessment of the level of consciousness, it is important to follow some simple steps. First, it is necessary to verify whether the subject is conscious or not. If not, immediately call the emergency number and start cardiopulmonary resuscitation maneuvers.

If instead the subject is conscious, proceed with evaluation of their mental state. To do this, use the Glasgow Coma Scale, which involves evaluating three parameters: eye opening, verbal response, and motor response.

It is important to remember that assessment of the level of consciousness should not be underestimated or neglected. Even a slight change in the Glasgow Coma Scale can indicate a deterioration in the general condition of the person being assisted.

Final recommendations:

• Properly train on the Glasgow Coma Scale and protocols to follow during a first aid procedure.
• Perform assessment of the level of consciousness accurately and systematically, always following the same steps.
• Act immediately in case of deterioration in the general condition of the person being assisted by calling the emergency number and adopting necessary measures to safeguard their life.

In conclusion, assessment of the level of consciousness is a crucial aspect during a first aid procedure that requires specific skills and great attention. Following the above final recommendations can make a difference between a correct first aid procedure and an ineffective or even harmful action for the health of the assisted subject.

Conclusion

Assessment of the level of consciousness is a crucial aspect during a first aid procedure. It allows for timely identification of any neurological problems or brain injuries that could endanger the life of the person being assisted. The Glasgow Coma Scale represents the main tool used to perform this assessment. It is important to properly train on this tool and protocols to follow during a first aid procedure. Additionally, it is important to perform assessment of the level of consciousness accurately and systematically, always following the same steps. Finally, acting immediately in case of deterioration in the general condition of the person being assisted can make a difference between a correct first aid procedure and an ineffective or even harmful action for the health of the assisted subject.