description: '**Concept**\r\nFifteen-point scale for expressing a person’s level of consciousness, from fully awake to deep unconsciousness, in a number: the so-called EMV score. \r\nThe Glasgow Coma Scale score or EMV (Eye-Motor-Verbal) score is a scale to measure the extent of consciousness, based on eye, verbal and motor responses to specific prescribed sound and pain stimuli.\r\n\r\n**Purpose**\r\nThe GCS score provides the opportunity to document a clinical observation of a patient’s conscious state with a validated instrument which makes use of a patient’s responses to stimuli.\r\n**Evidence Base**\r\nThe Glasgow Coma Scale is used to evaluate a patient’s consciousness by means of three elements: \r\n\r\n1. opening eyes (eye response); \r\n\r\n1. answering questions (verbal response); \r\n\r\n1. motor response. \r\n\r\n\r\nThe three response values are looked at individually and as a whole. The total is referred to as the EMV score. The minimum total score is 3 and the maximum is 15. A slightly altered scale is used for infants (age 0-2) and toddlers (age 2-5). \r\n\r\nThe EMV score can be expressed as a combination of each of the three individual scores, such as: E3M2V4 (opens eyes when spoken to, arms stretch in response to pain and patient produces incomprehensible sounds). \r\nIf one of the EMV elements cannot be evaluated - such as might be the case if a patient is intubated and incapable of verbally responding, or is paralyzed/weak and incapable of fulfilling the motor request, then the individual score is included (score NT), with an extra comment. Er moet dan GEEN totaalscore worden doorgegeven.\r\nV1T is used for an intubated patient, in which t = ''tube''. \r\nClinical decisions must be based on each of the specific data of the eyes, motor and verbal responses and, if evaluation is not possible, an explicit explanation. \r\n\r\nStandard values for the total score, depending on age: \r\n0-6 months : 9 and up\r\n6 months: 10 and up\r\n6-12 months : 11 and up \r\n1-2 : 12 and up \r\n2-5 : 13 and up \r\n> 5 : 14 and up\r\n**Example Instances**' package_name: healthdata.be.r4.cbb derivation: specialization name: HdBeGlasgowComaScale abstract: true type: https://fhir.healthdata.be/StructureDefinition/LogicalModel/glasgow_coma_scale elements: glasgow_coma_scale_date_time: short: GlasgowComaScaleDateTime _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Tijdstip waarop de EMV score werd bepaald.} type: dateTime _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: GlasgowComaScaleDatumTijd} base: {max: '1', min: 1, path: glasgow_coma_scale.glasgow_coma_scale_date_time} index: 0 gcs_eyes: short: GCS_Eyes _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: 'Beste response van de ogen op een stimulus. Het element is verplicht, maar er hoeft geen getalmatige waarde toegekend te zijn. Als er geen waarde is toegekend, dan wordt de reden hiervan vermeld in het concept ConditiesTijdensMeting.'} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: GCS_Eyes} binding: {strength: required, valueSet: 'https://fhir.healthdata.be/ValueSet/GCS_Eyes'} base: {max: '1', min: 0, path: glasgow_coma_scale.gcs_eyes} index: 1 gcs_motor: short: GCS_Motor _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: 'Beste motorische response op een stimulus. Het element is verplicht, maar er hoeft geen getalmatige waarde toegekend te zijn. Als er geen waarde is toegekend, dan wordt de reden hiervan vermeld in het concept ConditiesTijdensMeting.'} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: GCS_Motor} base: {max: '1', min: 0, path: glasgow_coma_scale.gcs_motor} index: 2 gcs_verbal: short: GCS_Verbal _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: 'Beste verbale response op een stimulus. Het element is verplicht, maar er hoeft geen getalmatige waarde toegekend te zijn. Als er geen waarde is toegekend, dan wordt de reden hiervan vermeld in het concept ConditiesTijdensMeting.'} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: GCS_Verbal} base: {max: '1', min: 0, path: glasgow_coma_scale.gcs_verbal} index: 3 total_score: short: TotalScore _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: 'De som van de EMV scores, uitgedrukt als getal in het bereik 3-15. De waarde hoeft niet te worden vastgelegd, omdat deze altijd op grond van de deelscores berekend kan worden, en omdat het vastleggen van het totaal bij een niet goed te bepalen deelscore niet gebruikelijk is.'} type: Count _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: TotaalScore} base: {max: '1', min: 0, path: glasgow_coma_scale.total_score} index: 4 conditions_during_measurement: short: ConditionsDuringMeasurement _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: 'Condities tijdens de meting die verhinderen dat een of meer van de subscores bepaald kan worden (niet testbaar), zoals bijvoorbeeld intubatie van het bepalen van GCS_Verbal.'} type: CodeableConcept _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: ConditiesTijdensMeting} array: true binding: {strength: extensible, valueSet: 'https://fhir.healthdata.be/ValueSet/ConditiesTijdensMeting'} base: {max: '*', min: 0, path: glasgow_coma_scale.conditions_during_measurement} index: 5 comment: short: Comment _definition: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: 'Opmerking over de (context van de) meting van de EMV score, zoals eventuele problemen of factoren die van invloed kunnen zijn op de interpretatie.'} type: string _short: extension: - url: http://hl7.org/fhir/StructureDefinition/translation extension: - {url: lang, valueCode: nl-NL} - {url: content, valueMarkdown: Toelichting} base: {max: '1', min: 0, path: glasgow_coma_scale.comment} index: 6 package_version: 0.4.1-alpha class: logical kind: logical url: https://fhir.healthdata.be/StructureDefinition/LogicalModel/HdBe-GlasgowComaScale base: http://hl7.org/fhir/StructureDefinition/Element version: null required: [glasgow_coma_scale_date_time]