Iyini i-GCS (Glasgow Coma Scale) esetshenziswa odokotela ukuhlola ukuqonda komuntu oseduze nawe?

Kungenzeka ukuthi uke wezwa, noma wezwa udokotela ekhuluma ngalezi zinhlamvu ezintathu ezithi "GCS" esibhedlela. Mhlawumbe lapho othile oseduze nawe eba nengozi, noma elahlekelwa ingqondo ngokuzumayo, odokotela bakhuluma ngaleli nani le-GCS. Ngakho-ke, iyini le GCS, kungani ibaluleke kangaka, futhi iyilinganisa ini ngempela, ake sixoxe ngokuningiliziwe nangokulula kakhulu namuhla. Umgomo wami ukukunikeza ukuqonda okucacile ngalokhu.

Kalula nje, iyini i-GCS (Glasgow Coma Scale)?

I-GCS, uma sikhuluma iqiniso, iyindlela yokulinganisa izinga lokuqwashisa komuntu. Ifana nohlelo lokuthola amaphuzu. Ithola amaphuzu njengokuthi uqaphile kangakanani, ukuthi uqaphela kangakanani indawo ekuzungezile, nokuthi usabela kahle kangakanani emiyalweni elula.

Lolu hlelo lwaqala ukwethulwa ngo-1974 yithimba lochwepheshe eNyuvesi yaseGlasgow eScotland. Naphezu kwegama elithi "coma" egameni, i-GCS manje isetshenziswa kakhulu kwezokwelapha. Yisilinganiso esiyinhloko nesisetshenziswa kakhulu esisetshenziswa ukukala izimo zokungazi kahle, okuhlanganisa ne-coma.

Kuyini "ukuqonda" ngokwezokwelapha?

Uma sikhuluma "ngokuqaphela" kwezokwelapha, kunezidingo ezintathu eziyinhloko. Ukuze umuntu kuthiwe uyazi, lezi zinto kumele zigcwaliseke:

• I-Phaphama: Lokhu kubhekisela ekutheni othile angakuvusa yini uma ukhuluma noma uthinta umzimba wakho. Lona umehluko phakathi kokulala nje nokuba se-coma.
• Ukuqaphela: Lokhu kusho ukuthi uphendula kanjani lapho othile ekhuluma nawe, ukuthi ukuphi, nokuthi ungakuqonda yini okwenzekayo eduze kwakho.
• Udinga ukuqaphela (Ukuthambekela): Lokhu kusho ukuthi uyazi imininingwane ehambisana nesimo sakho samanje, njengokuthi ungubani, ukuphi, nokuthi usuku luni.

Uma zonke lezi zinto ezintathu zikhona, sithi othile "unengqondo ephilile."

Isetshenziswa nini i-GCS (Glasgow Coma Scale)?

Odokotela bangasebenzisa i-GCS njengengxenye yokuhlolwa kwezinzwa . Iwusizo futhi kunoma yisiphi isimo lapho umuntu engase alahlekelwe ukuqonda. Isibonelo, ezimweni ezibangelwa ukulimala ekhanda, njengokushayisana kwemisipha kanye nokulimala kobuchopho okubuhlungu (i-TBI) .

Akukhona lokho kuphela, kodwa isikali se-GCS siyasiza nasezimweni zokulahlekelwa ukwazi ngenxa yezinye izimbangela ngaphandle kokulimala. Isibonelo, sisetshenziswa ezimweni zamazinga kashukela aphansi kakhulu egazini (i-hypoglycemia) , ubuthi, noma ngemva kokuquleka.

Ilinganisa ini i-GCS (Glasgow Coma Scale)?

Ukuhlolwa kwezinzwa kubheka noma yiziphi izinkinga ngokusebenza kwezingxenye ezimbili eziyinhloko zesimiso sethu sezinzwa. Lezi zingxenye ezimbili yilezi:

• Isistimu yezinzwa ephakathi: Lokhu kufaka phakathi ubuchopho bakho, i-brainstem, i-optic nerves exhumanisa ubuchopho ne-retina ngemuva kwamehlo akho, kanye nentambo yomgogodla.
• Isimiso sezinzwa esingaphandle: Lokhu kubhekisela kuzo zonke izinzwa ezingeyona ingxenye yesimiso sezinzwa esiphakathi.

Kunezindawo ezintathu eziyinhloko ze-GCS ezihambisana nalokhu kuhlolwa kwezinzwa. Iningi lalezi zihlobene nobuchopho uqobo, kodwa ezinye zingabandakanya nomgogodla kanye nemizwa kuwo wonke umzimba:

• Impendulo yamehlo: Lokhu kuhlobene kakhulu nokuthi uphapheme futhi uqaphile kangakanani.
• Impendulo yemisipha: Lesi sigaba sibheka ukuthi ubuchopho bakho bungakwazi kanjani ukulawula ukunyakaza kwemisipha. Singathola futhi noma yiziphi izinkinga ngokuxhumana phakathi kobuchopho bakho nezinye izingxenye zomzimba wakho.
• Impendulo ngamazwi: Lokhu kuhlola ukuthi imisebenzi ethile yobuchopho isebenza kahle kangakanani, njengokucabanga, inkumbulo, ukunaka, kanye nokuqaphela okukuzungezile.

Isebenza kanjani i-GCS (Glasgow Coma Scale)?

Ukuze bathole amaphuzu akho e-GCS, odokotela bahlanganisa amaphuzu avela ezigabeni ezintathu zangaphambilini ze-GCS. Udokotela uzohlola ngayinye yalezi zigaba ngezindlela ezahlukene. Isibonelo, bazobheka impendulo yakho ngomlomo bese bekubuza imibuzo embalwa. Yiluphi usuku lwesonto namuhla, yisiphi isikhathi, futhi ukuliphi idolobha njengamanje?

Enye yezinzuzo ezibaluleke kakhulu ze-GCS ukuthi ingaqapha izinguquko ezingeni lakho lokuqwashisa. Odokotela bavame ukuphinda lokhu kuhlolwa kwezinzwa ngezikhathi ezithile futhi baqophe izinguquko kumaphuzu e-GCS.

Nansi indlela lezi zigaba ezinikezwa ngayo amaphuzu:

Impendulo Yeso

Lokhu kukala kakhulu ukuthi uphapheme kangakanani. Uma ungazi lutho, izinga lakho lokungazi lutho lilinganiswa ngokuhlola izimpendulo zakho ze-reflex ekucindezelweni. Lapha, "ukucindezela" kuyinto efana nokucindezela okuncane okunozipho. Kufanele kubangele ukungakhululeki okuncane, kwesikhashana, hhayi ukulimala.

Impendulo Yomlomo

Udokotela uzokuhlola lokhu ngokukubuza imibuzo elinganisa inkumbulo yakho, ikhono lokucabanga, kanye nokuqaphela okukuzungezile. Angahlola futhi izinkinga zobuchopho noma imizwa elawula imisipha ebusweni bakho nasemlonyeni.

Impendulo Yemoto

Lesi sigaba singaveza noma yiziphi izinkinga ngokuxhumana phakathi kwezinzwa zakho, umgogodla, kanye nobuchopho. Siphinde sihlole ikhono lobuchopho bakho lokulawula ukunyakaza kwemisipha nokuthi ungaqonda futhi wenze ngokwemiyalelo.

Kuyini i-GCS-P?

Ngo-2018, ithimba lochwepheshe — okubalwa nomunye wabadali bokuqala be-GCS — lakhipha inguqulo ebuyekeziwe ye-GCS, ebizwa ngokuthi "GCS-P." I-P imele "Umfundi," umgodi omnyama ongaphakathi kweso. Lena inombolo yesine ethathwe kumaphuzu ajwayelekile e-GCS.

Indlela inhlamvu yeso esabela ngayo ekukhanyeni (ukusabela komfundi) ibaluleke kakhulu ngoba inikeza izinkomba mayelana nokusebenza kobuchopho. Uma inhlamvu yakho ingaphenduli ekukhanyeni, kungabonisa inkinga enkulu noma ukulimala okuthinta ubuchopho.

Amaphuzu anikezwa umfundi asukela ku-0 kuya ku-2.

• 2: Zombili izinhlayiya ze-cornea aziphenduli ekukhanyeni.
• 1: Umfundi oyedwa akasabeli ekukhanyeni.
• 0: Zombili izinhlayiya ze-cornea ziyasabela ekukhanyeni.

Uma amaphuzu okuphendula komfundi esuswa kumaphuzu e-GCS, amaphuzu e-GCS-P angasukela ku-1 kuya ku-15. Amaphuzu e-GCS-P angu-8 noma ngaphansi abonisa i-coma.

Isibonelo, uma amaphuzu e-GCS engu-3 kanti amaphuzu e-iris angu-2, amaphuzu e-GCS-P angu-1. Lokhu kusho ukuthi i-coma ejulile kakhulu futhi ama-iris kuwo womabili amehlo awasabeli ekukhanyeni.

Ingabe kukhona ubuhlungu ngesikhathi sokuhlolwa kwe-GCS?

Izincazelo ezindala ze-GCS zisebenzisa igama elithi "ubuhlungu" ukuchaza umuzwa osetshenziswa ukuhlola ukusabela okuthile. Kodwa-ke, iziqondiso ezintsha zishintshe lelo gama laba "ukucindezeleka." Lokhu kushintsha kwamagama kunembe kakhulu, ngoba akukho ukulimala okuhilelekile. Kusobala futhi ngoba udokotela empeleni akazami ukubangela ubuhlungu noma ukulimaza othandekayo wakho.

Iziqondiso zokuqala ze-GCS azizange zisho ngokusobala ukuthi kufanele kusetshenziswe kuphi ingcindezi yokuhlola i-reflexes. Ngo-1975, unyaka ngemuva kokushicilelwa kwe-GCS okokuqala, ochwepheshe abayisungulile bashicilela iziqondiso ezithile. Nazi ezinye zezindawo udokotela angase asebenzise ingcindezi kuzo:

• Imibhede yezinzipho: Izinzipho ezandleni nasezinyaweni zakho zizwela ukucindezeleka. Odokotela bavame ukucindezela okukodwa noma ngaphezulu kwalokhu ukuze babone ukuthi umzimba usabela ngendlela eqondile kulokho kucindezeleka.
• Umsipha we-Trapezius: Lo msipha uxhumanisa amahlombe akho, intamo ephakathi nendawo kanye nomhlane. Kulula ukuwufinyelela ukuze uthole i-reflex yokucindezela.
• I-Supraorbital notch: Lokhu kuyi-depression encane ekhanda lakho, ngaphezu kwamehlo akho nangaphansi kwamashiya akho.

Iyini imiphumela, futhi isitshelani?

Isilinganiso esiphezulu kakhulu ku-GCS singama-15, kanti isilinganiso esincane kakhulu singama-3.Isilinganiso esingu-15 sisho ukuthi uphapheme ngokuphelele, uyasabela, futhi awunazinkinga ngokucabanga noma ngenkumbulo yakho. Ngokuvamile, isibalo esingu-8 noma ngaphansi sisho ukuthi use-coma. Uma isibalo siphansi, i-coma ijula ​​kakhulu.

Odokotela bangabhala amaphuzu akho e-GCS njengenhlanganisela yezinhlamvu/izinombolo. Isibonelo, amaphuzu angu-15 angabhalwa ngokuthi "E4V5M6". Amaphuzu angu-3 angabhalwa ngokuthi "E1V1M1". (E=Eye, V=Verbal, M=Motor)

Ububanzi be-GCS bokulimala ekhanda

Uma odokotela besebenzisa i-GCS ekulimaleni ekhanda, basebenzisa amazinga ahlukene ukuchaza ubukhali bokulimala. Lawa mazinga alandelayo:

• 13 kuya ku-15: Ukulimala Okuncane Kobuchopho Obubuhlungu (mTBI). Lokhu kubizwa nangokuthi i-concussion .
• 9 kuya ku-12: I-TBI Emaphakathi.
• 3 kuya ku-8: Ukulimala okukhulu kobuchopho (i-TBI Enzima).

Yini okufanele ngiyazi ngesilinganiso se-GCS somuntu oseduze nami?

Ngokuvamile, umndeni wakho noma abathandekayo bakho bazoxoxa ngesikolo sakho se-GCS nodokotela wakho. Kunezinto ezimbalwa okufanele uzazi nge-GCS nokuthi odokotela bayisebenzisa kanjani:

• Imiphumela yokuhlolwa iyinkimbinkimbi kakhulu kunenombolo nje. Isilinganiso se-GCS asikutsheli ububanzi obugcwele bemiphumela yokuhlolwa. Kunokuningi okuhlolwa kwezinzwa kunenombolo nje. Nakuba kulula ukuqonda inombolo, kungcono ukukhuluma nodokotela womuntu omthandayo ukuze uqonde isimo sakhe esiqondile.
• I-GCS nayo inemikhawulo. Kwezinye izimo, i-GCS ingase ingabi usizo. Isibonelo, uma umuntu esebenzisa umshini wokuphefumula , noma uma engakhulumi ulimi olufanayo nodokotela. Ingase futhi ingabi usizo kubantu abanezimo noma ukulimala okuthinta izingxenye zomzimba noma izinhlelo i-GCS ethembele kuzo (isib., ukukhubazeka kokubona noma kokuzwa).
• I-GCS akuyona yodwa into odokotela abayisebenzisayo ukubikezela ukubikezela. Odokotela bavame ukusebenzisa i-GCS ukubikezela imiphumela engaba khona, kodwa akuyona yodwa into abayicabangayo. Buza udokotela womuntu omthandayo ngamaphuzu akhe nokuthi angasho ukuthini esikhathini eside.

Khumbula, amaphuzu e-GCS ayithuluzi elilodwa nje. Nakuba enikeza ulwazi olubalulekile, ukuxhumana okuhle nethimba lezokwelapha kubalulekile ukuze kuqondwe isithombe esiphelele.

Okokugcina, okufanele ukukhumbule

Isikali se-Glasgow Coma (GCS) siyithuluzi elivamile nelibalulekile elisetshenziswa odokotela ukukala amazinga okulahlekelwa ukwazi kanye ne-coma.Ngisho noma sekuphele iminyaka ecishe ibe ngu-50 kusukela yasungulwa okokuqala, ochwepheshe baye bafunda kabanzi ngalesi silinganiso futhi bathola ukuthi siyithuluzi lokuxilonga eliwusizo. (Baphinde basithuthukisa ngokuhamba kwesikhathi.) Ukusebenzisa leli thuluzi kusiza odokotela ukulandelela izinguquko ekusebenzeni kobuchopho. Lokhu kungasiza ekuqondiseni ukwelashwa futhi kuthuthukise ukunakekelwa kwabantu abanezimo ezithinta ukuqonda.

Uma wena noma othile oseduze nawe ebhekene nalokhu, ungesabi ukubuza imibuzo nokuthola ulwazi kodokotela bakho. Bakulungele futhi bazimisele ukukusiza.

Ukuqaphela , i-GCS, i-Glasgow Coma Scale, Ukulimala Kobuchopho, i-Coma, Ukuhlolwa Kwezinzwa, Impilo