Èkpɔ ɖɔktawo wobia kpɔ be, "Nukae nye GCS ƒe dzesi?" ne wokplɔ ame aɖe va kɔdzi le afɔku aɖe megbe? Alo ne ame aɖe ƒe susu bu la, wogblɔna be, "GCS la le sue"? Ðewohĩ ànɔ nusi GCS sia nye kple nusi wòdzidzena hã ŋu bum. Esia le vevie ŋutɔŋutɔ. Eyata egbea, mina míaƒo nu tso eŋu bɔbɔe ŋutɔ, le mɔ si gɔme nàte ŋu ase nu.
Nukae GCS fia ko?
Kpuie ko la, Glasgow Coma Scale (GCS) nye dzesideɖoɖo si dzidzea ame ƒe susu ƒe seƒe hedaa eƒe dzeside. Abe dodokpɔ ƒe dzeside nana ene la, enaa ɖɔktawo te ŋu bua alesi ame le ŋudzɔe, alesi wònya nu tso nusiwo ƒo xlãe ŋu, kple alesi wòwɔa nu ɖe mɔfiame bɔbɔewo ŋui ŋu.
Eŋutinunyala bibiwo ƒe ƒuƒoƒo aɖe si le Glasgow Yunivɛsiti le Scotland ye to mɔnu sia vɛ zi gbãtɔ le ƒe 1974 me. Esia tae wòxɔ ŋkɔ ɖo. Togbɔ be nya "kɔma" le ŋkɔa me hã la, egbea eva zu mɔnu vevitɔ si dzi woda asi ɖo le xexeame, menye le kɔdzi ɖeɖeko me o, ke wozãnɛ le nɔnɔme ɖesiaɖe si me susu ate ŋu agblẽ le hã me.
Nukae nye ‘Sidzedze’ le atikewɔwɔ me?
Míegblɔna be ‘sidzedze’ ne wodo go nu vevi etɔ̃. Ne ɖɔkta dzidze wò susu la, woƒe susu nɔa nu etɔ̃ siawo ŋu.
| Nya lae nye ema | Numeɖeɖe bɔbɔe |
|---|---|
| Ŋudzɔnɔnɔ (Nyɔ) . | Esia mele abe nyɔnyrɔ̃ tso alɔ̃ me ko ene o. Àte ŋu anyɔ ne ame aɖe le nu ƒom na wò, alo ne èle asi ƒom na wò ŋutilã. Màte ŋu anyɔ ame aɖe si le kɔmam alea o. |
| Ŋute | Ŋutete si le asiwò be nàse nuwo abe nusiwo le edzi yim ƒo xlã wò kple amesi le nu ƒom ene gɔme. |
| Teƒe-ɣeyiɣi-ame gɔmesese (Oriented) . | Afisi nèle kple ɣeyiɣi si nèle, abe amesi nènye, afisi nèle, ŋkeke si wònye, kple gaƒoƒo si wònye ene nyanya. |
Ɣekaɣie wozãa GCS?
GCS nye ahɔhɔ̃mekawo ƒe dodokpɔ si ɖɔktawo wɔna ƒe akpa vevi aɖe ŋutɔ. Wozãnɛ vevietɔ le nɔnɔme siwo me ame aɖe ate ŋu anɔ nu bum le.
- Ta ƒe abixɔxɔ: Wozãa GCS tsɔ daa nusianu kpɔ tso abi suewo abe ʋuʋudedi ene dzi va ɖo ahɔhɔ̃ me abi sesẽ siwo gblẽa nu le ame ŋu dzi. GCS ƒe dzesi nye nu vevi siwo ŋu ɖɔktawo léa ŋku ɖo ne wokplɔ ame va ETU (Emergency Treatment Unit) le afɔku aɖe megbe la dometɔ ɖeka.
- Atikewɔwɔ ƒe nɔnɔme bubuwo: Nudzɔdzɔ aɖewo hã li siwo me ame ƒe susu ate ŋu abu le afɔku manɔmee gɔ̃ hã. Le kpɔɖeŋu me:
- Sukli ƒe agbɔsɔsɔ si bɔbɔ ŋutɔ le ʋu me (suklidɔ ƒe agbɔsɔsɔ si medea ame dzi o) .
- Le alɔ̃madɔmadɔ aɖe megbe
- Aɖi tsɔtsɔ de ame me
Vevietɔ: Ne ame aɖe ɖu aɖi aɖe alo ɖui le vo me la, ele be woabia atikewɔlawo ƒe aɖaŋuɖoɖo enumake. Àte ŋu aƒo ka na Dukɔa ƒe Aɖi Ŋuti Nyatakaka Dɔwɔƒe si le Colombo Dukɔa ƒe Kɔdzi axɔ aɖaŋuɖoɖo kaba.
Nukae nye GCS ƒe dzesidede ƒe akpa vevi 3?
Ðɔkta aɖe nɔa te ɖe dɔnɔa ƒe ŋuɖoɖowo dzi le nu vevi etɔ̃ me naa GCS ƒe dzesi. Wobua GCS ƒe xexlẽdzesi bliboa to nuto etɔ̃ siawo tsɔtsɔ ƒo ƒui me.
1. Ŋku ƒe Ŋuɖoɖo (E): Esia koŋ dzidzea alesi amea le ŋudzɔ hele ŋudzɔe.
2. Nuƒoƒo ƒe Ŋuɖoɖo (V): Esia doa ahɔhɔ̃a ƒe dɔwɔwɔwo abe ame ƒe tamebubu ŋutete, ŋkuɖoɖonudzi, kple xexe si ƒo xlãe ƒe sidzedze ƒe ŋutete kpɔna.
3. Motor Response (M): Esia doa alesi ahɔhɔ̃a te ŋu ɖua lãmekawo dzi nyuie, wɔa ɖe mɔfiamewo dzi, kple nenye be lãmekawo le dɔ wɔm nyuie hã kpɔna.
Azɔ mina míakpɔ alesi míade dzesi akpa siawo dometɔ ɖesiaɖe.
| Ŋuɖoɖo | Alesi woalé ŋku ɖe eŋu ahaɖe nɔnɔme afia | Do age |
|---|---|---|
| 1. Ŋku ƒe Ŋuɖoɖo (E) . | ||
| Le eɖokui si | Dɔnɔa mewɔa naneke o la, le dzɔdzɔme nu la, eƒe ŋkuwo ʋuna. | 4. 4. |
| Ne woƒo nu kplii | Woʋua ŋku ne woyɔ woƒe ŋkɔ alo ne wose nane. | 3. 3. |
| Na vevesese/nyaƒoɖeamenu | Ne wozi asibidɛ aɖe dzi vie (wozi edzi) la, ŋkuawo ʋuna. | 2. 2. |
| Ŋuɖoɖo aɖeke meli o. | Mɔ aɖeke meli si dzi nàto aʋu ŋku o. | 1. 1. |
| 2. Nyaŋuɖoɖo (V) . | ||
| Kple gɔmesese | Ne wobia amesiwo wonye, afisi wole, kple alesi woƒe ŋkekea le hã la, woɖoa eŋu pɛpɛpɛ. | 5. 5. |
| Tɔtɔtɔe | Wole nu ƒom, gake womenya afi si tututu wole alo nusi dzɔ o. Wole nu ƒom le tɔtɔ me. | 4. 4. |
| Nya siwo mesɔ o | Woƒoa nu, gake wogblɔa nya siwo gɔmesese aɖeke mele o siwo meku ɖe nya si wobia la ŋu kura o. | 3. 3. |
| Gbeɖiɖi siwo gɔme womate ŋu ase o | Womegblɔa nyawo o, ke boŋ ɖeko wowɔa gbeɖiɖi siwo gɔmesese aɖeke mele o abe hũɖeɖe ene. | 2. 2. |
| Ŋuɖoɖo aɖeke meli o. | Mewɔa gbeɖiɖi aɖeke o. | 1. 1. |
| 3. Mɔ̃ ƒe Ŋuɖoɖo (M) . | ||
| Mɔfiamewo dzi wɔwɔ | Wowɔna ɖe mɔfiame bɔbɔewo abe "kɔ wò asi dzi" kple "do wò aɖe ɖe ŋgɔ" ene pɛpɛpɛ. | 6. 6. |
| Eƒe susu tsɔtsɔ ɖe vevesesea ŋu | Ne wote ametia ƒe akpa aɖe la, amea dzea agbagba be yeaka asi teƒe si le veve sem la ŋu alo aɖee ɖa. | 5. 5. |
| Vevesese ɖeɖeɖa | Le esi teƒe be woadze agbagba aka asi teƒe si le veve sem la, wodzea agbagba be yewoate yewo ɖokui ɖa tso vevesesea gbɔ. | 4. 4. |
| Blibo si mele dzɔdzɔme nu o | Le vevesese ta la, abɔ kple afɔawo bɔbɔna ɖe akɔta le mɔ si mele dzɔdzɔme nu o nu. | 3. 3. |
| Kekeɖenudɔwɔwɔ si mele dzɔdzɔme nu o | Le vevesese ta la, abɔ kple afɔawo zɔna eye wokekena le mɔ si mele dzɔdzɔme nu o nu. | 2. 2. |
| Ŋuɖoɖo aɖeke meli o. | Ŋutilã ƒe ʋuʋu aɖeke meli o. | 1. 1. |
Nukae nye mɔnu yeye si woyɔna be GCS-P?
Nyitsɔ laa la, wogatrɔ asi le GCS ɖoɖoa ŋu eye wotsɔ nu yeye aɖe si woyɔna be GCS-P kpee. Le afisia la, ŋɔŋlɔdzesi ‘P’ tsi tre ɖi na ‘Nuvi’, si gɔmee nye ŋku ƒe ŋkume . Alesi sukuvia wɔa nui ɖe kekeli ŋu ate ŋu agblɔ nu geɖe tso ahɔhɔ̃a ƒe dɔwɔwɔ ŋu. Eyata woléa ŋku ɖe esia hã ŋu kpe ɖe GCS ƒe dzesi ŋu.
- Dzesi 0: Kplɔ̃ yibɔ siwo le ŋku eveawo me la wɔa nu ɖe kekeli ŋu.
- Dzesi 1: Ŋku ɖeka koe ɖoa eŋu.
- Dzesi 2: Ŋuɖoɖo aɖeke menɔ ŋku eveawo ŋu o.
Woɖea dzesi sia le GCS ƒe dzesi si woxɔ va yi la me. Eyae nye be ne GCS ƒe xexlẽdzesi nye 3 eye ŋuɖoɖo aɖeke mele ŋku eveawo me o (dzesi 2) la, GCS-P ƒe dzesi nye 1 (3 - 2 = 1). Esia fia be dɔnɔa le alɔ̃madɔmadɔ si de to ŋutɔ me.
Nukae dzesiawo gblɔ?
GCS ƒe dzesiwo ƒe ƒuƒoƒo ate ŋu ana woanya dɔnɔa ƒe nɔnɔmea nyuie.
- Dzesi si sɔ gbɔ wue nye 15. (E4 + V5 + M6 = 15). Esia fia be dɔnɔa ƒe susu nɔa nu ŋu bliboe, eƒoa nu nyuie, eye wònyaa nusiwo ƒo xlãe.
- Dzesi si bɔbɔ wue nye 3. (E1 + V1 + M1 = 3). Esia fia be dɔnɔa le alɔ̃madɔmadɔ me, eye mewɔa nu ɖe eŋu o.
Zi geɖe la, wobua GCS ƒe dzesi si nye 8 alo esi mede nenema o be enye alɔ̃madɔmadɔ. Zi alesi dzesia ɖiɖi la, zi nenemae nɔnɔmea nu sẽna ɖe edzii.
Le ta ƒe abixɔxɔ me la, wodaa abi la ƒe sesẽme ɖe hatsotsowo me le GCS ƒe dzesi nu.
- Dzesi 13-15: Ahɔhɔ̃ ƒe abi si nu sẽ si mesẽ o - abe ʋuʋudedi ene.
- Dzesi 9-12: TBI si le titina.
- Dzesi 3-8: TBI sesẽ.
Nukae wòle be manya tso vinye ƒe GCS ƒe dzesi ŋu?
Ne wò ƒometɔ alo xɔ̃wò aɖe xɔ kɔdzi eye ɖɔktawo le nu ƒom tso GCS ƒe dzesiwo ŋu la, mègatsi dzodzodzoe o eye nu siawo nanɔ susu me na wò.
- Menye dzesi aɖe koe esia nye o. Togbɔ be GCS ƒe dzesidea naa wokpɔa dɔnɔa ƒe nɔnɔmea nyuie hã la, nyatakaka geɖe le megbe nɛ. Eyata le esi teƒe be nàɖo to dzesideŋkɔa ko la, ƒo nu kple wò ɖɔkta be nàkpɔ dɔnɔa ƒe nɔnɔmea ƒe nɔnɔmetata bliboe.
- Womate ŋu azã GCS ɣesiaɣi o. Le go aɖewo me la, womate ŋu adzidze GCS ƒe dzesiwo nyuie o. Le kpɔɖeŋu me, ne wotsɔ ame aɖe do ka kple yagbɔgbɔmɔ̃ be wòakpe ɖe eŋu wòagbɔ ya la, womate ŋu adzidze nuƒoƒo ƒe ŋuɖoɖo o. Azɔ hã, ne woxɔ abi ŋkuawo la, womate ŋu akpɔ ŋku ƒe ŋuɖoɖowo o.
- Menye GCS koe nye dɔwɔnu si wozãna tsɔ gblɔa nusiwo ava dzɔ ɖi o. Togbɔ be ɖɔktawo zãa GCS ƒe dzesiwo tsɔ gblɔa dɔnɔ aɖe ƒe etsɔme ɖi hã la, womeléa ŋku ɖe eŋu ɖeɖeko o. Wobua dodokpɔ bubuwo, abe CT-dɔdamɔnu ene, kple dɔnɔa ƒe lãmesẽ bliboa hã ŋu.
Gbedasi si Wotsɔ Yi Aƒeme
- Glasgow Coma Scale (GCS) nye dzesideɖoɖo si dzi woda asi ɖo le dukɔwo dome si dzidzea ame ƒe susu.
- Esia doa ŋuɖoɖowo kpɔna to ŋkuwo, nuƒoƒo, kple ŋutilã ƒe ʋuʋu me.
- Dzesiawo tso 3 (deep coma) va ɖo 15 (sidzedze blibo). Wobua dzesi si nye 8 alo esi mede nenema o be enye nu sesẽ.
- Ne ɖɔktawo léa ŋku ɖe GCS ƒe dzesi ŋu edziedzi la, woate ŋu ase egɔme nenye be dɔnɔa ƒe nɔnɔmea le nyonyom ɖe edzi alo le gbegblẽm ɖe edzi.
- Ne èva nya nu tso wò lɔlɔ̃tɔ aɖe ƒe GCS ƒe dzesi ŋu la, mègatsi dzi ɖe xexlẽmea ŋu ko o. Ƒo nu kple wò ɖɔkta ɣesiaɣi eye nàse nɔnɔme bliboa gɔme nyuie.
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