OPTION 1

To assess the level of consciousness “Glasgow coma scale” is used. This scale relates clinical observations for motor response, verbal response and eye examination and its responses. The skull or cranium examination should be carried out for any obvious lacerations or fractures.

 

Level of consciousness should also be assessed:

•            Fully conscious

•            Drowsy patient with disorientation, but responds rationally to spoken questions

•            Semiconscious patient, responding irrationally to spoken questions

•            Unconscious patient, but responds to painful stimuli (semi coma)

•            Unconscious with no response to painful stimuli (coma).

•            The degree and duration of loss of consciousness is an important indication for the severity of the cerebral damage.

 

Key concept:

 

•            Whenever, patient is admitted in an unconscious state with maxillofacial injuries, it may not be due to head injury. Sudden loss of consciousness may be following epileptic fits or cerebral and cardiovascular disasters.

•            The level of consciousness may be also influenced by the action of alcohol or other drugs intake, hypoglycemia or hyperglycemia. Eyes, the spine, the limbs, abdomen and chest should be checked properly.

•            Specialist consultations from neurologist, ophthalmologist and general surgeon should be sought in cases of extensive injuries.