TBI

Initial examina tion

GCS

Infants & children

Adults

Eyes

GCS
Verbal Motor

 Eyes
Open spontaneusly

4 Open to verbal command 3 Open in response to pain applied to the limb or sternum 2 None 1

 Verbal
Oriented

5 Disoriented, but able to answer question 4 Inapproriate answer to question; words discernible 3 Incomprehensible speech 2 None 1

Motor
Obey commands Responds to pain with purposively

movement 5 Withdraws from pain stimuli 4 Responds to pain with abnormal flexion 3 Responds to pain with abnormal extension 2 None 1

 Interpretasi

Mild TBI

Moderate TBI
Severe TBI

13-15 9-12 3-8 coma

 Mild TBI observasi at home Moderate TBI observasi at

hospital Severe TBI rapid sequence intubation, intensive supportive care, monitoring of increased intracranial pressure as indicated

Eyes Opens eyes spontaneusly 4 Opens eyes in response for speech 3 Opens eyes in response to painfull stimuli 2 Does not open eyes 1

Verbal
Smiles, orientated to sounds, follow objects,

interacts 5 Cries but consolable, inappropriate interactions 4 Inconsistantly inconsolable, moaning 3 Inconsolable, agitated 2 No verbal response 1

Motor
Infant moves spontaneusly or purposively 6 Infant withdraws with touch

5 Infant withdraws from pain 4 Abnormal flexion to pain (decorticate response) 3 Extension to pain (decerebrate response) 2 No motor response 1

 Interpretasi

Mild TBI

Moderate Tbi
Severe TBI

13-15 9-12 3-8 coma

< 1 years

> 1 years

Eyes

Open spontaneusly Open in response to verbal stimuly Open in response to pain only No response

Open spontaneusly Open in response to verbal stimuly Open in response to pain only No response

4 3

0-23 months

2-5 years

> 5 years

Verbal

Coos & babbles

Appropriate Oriented, words & phrases appropriate Inappropriate words Confused

Irritable cries

Cries in Cries in Inappropriate response to pain response to pain words

Moans in Moans in Incomprehensib 2 response to pain response to pain le words or non spesific sounds No response No response No response 1

< 1 years

> 1 years

Motor

Moves spontaneusly & purposively

Withdraws to touch Withdraws in response to pain Response to pain with decorticate posturing Response to pain with decerebrate posturing No response

Obey commands
Localized painfull stimulus Withdraws in response to pain Response to pain with decorticate posturing Response to pain with decerebrate posturing No response

6
5 4

Komposmentis: sadar sepenuhnya, memberi respons yg adekuat thd stimulus yg diberikan Apatis: sadar, acuh tak acuh, respons adekuat bila ada stimulus Somnolen: mengantuk, tdk respons thd stimulus ringan, tapi respons thd stimulus yg keras, lalu tidur lg Sopor: tdk respons thd stimulus ringan, sdkt respons thd stimulus yg kuat, refleks cahaya (+) Koma: tdk bereaksi thd stimulus, refleks cahaya (-) Delirium: disorientasi, iritatif, salah persepsi thd rangsang, ada halusinasi