Page 31 - AACN Essentials of Critical-Care Nursing Pocket Handbook, Second Edition
P. 31

Abnormal motor responses. (A) Decorticate posturing. (B) Decerebrate pos-
                                                    turing. (C) Decorticate posturing on right side and decerebrate posturing on left
                                                      side of body. (Reprinted from: Carlson BA. Neurologic clinical assessment. In: Ur-
         18







                                                          Management. St Louis, MO: Mosby; 2002:649.) den LD, Stacy KM, Lough ME, eds. Thelan’s Critical Care Nursing: Diagnosis and






















              Glasgow Coma Scale  Score a  4  3  2  1  6  5  4  3  2  1  5  4  3  2  1 a Coma score   E   M   V (scores range 3-15).












                 Behavior  Eye Opening (E)  Spontaneous  To verbal stimuli  Motor Response (M)  Obeys commands  Localizes pain  Withdraws to pain  Abnormal flexion  Extensor response  Verbal Response (V)  Inappropriate words Incomprehensible sounds
              2.9        To pain  None  None  Oriented  Confused  None
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