Unconscious Patient, Haematemasis & Melaena [Case #1]

“For each of the cases below read the description and calculate the GCS. Try to do it from memory rather than looking up the breakdown, this can easily come in part B of MCEM.”

Questions

Answer the questions before attending the face-to-face teaching session. Add comments to answers already given if you think it's appropriate. The first part of teaching will be spent discussing this case.

1. An 18 year old student has been brought in after drinking at a party. He will open his eyes when you talk to him, but does not know where he is. He grabbed your FY1's hand when she tried to cannulate him.

2. A young man has come off of his motorbike, he is mumbling and groaning, he did not move when an orange cannula was inserted in his hand but did open his eyes.

3. A jaundiced lady is confused, pulls her hand away when pressure is applied to her nail bed, and will open her eyes to a sternal rub.

4. A diabetic man has been found clammy and unresponsive, he groans to painful stimulus but does not open his eyes. He flexes to pain.

5. An intubated patient on ITU, is able to open their eyes on command and to squeeze your hand.

6. A collapsed pregnant lady who extends to a painful stimulus, has not opened her eyes or verbalised.

7. A one year old crying inconsolably and withdrawing to touch, they open their eyes to speech.