Rubbing the sternum is not recommended as it can cause soft-tissue damage and the responses to it are not predictable or reliable. GCS-40 now instructs clinicians to apply pressure in three specific locations, as needed, to note the increasing intensity required to elicit response.īegin with pressure to the fingertips, then move to the trapezius muscle and finally the supraorbital notch if needed. The changes to the Scale, now referred to as GCS-40, fall into three categories. Led by Sir Graham, a team from the Institute of Neurological Sciences updated the GCS and developed a Structured Approach to Assessment to minimize the variation in application of the original version of the Scale. Remember 2 Things: Fine tune use of the Glasgow Coma Score
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