GCS question

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joeboo

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Real quick y'all,

We had a patient who was alert and oriented to 4.

However, during transport pt kept going on and on about how nursing home officials and his family members could read his mind, and a couple of times checked over his shoulder to make sure none of the aforementioned were in the ambulance with us. aside from that, pt was pleasant and agreeable.

I gave him a GCS of 14 due these bizarre comments and behavior.

My partner disagreed, and said he was a 15, due to the fact that he could carry on a conversation and was A&O x 4.


THoughts?
 
crazy does not alter the gcs score. 15
 
Agreed. Now, what they score on the TFN scale is a different story.
 
If truly oriented, he is 15. If you can argue that he's confused and not sure what's going on (versus delusional), you can dock him one on verbal response.
 
I agree. If the patient knows he is in Chicago, and it is 2013 he still has a GCS of 15 even if he is convinced little green aliens are following him around. If he thinks he is on a colony on Mars and it is 2213 he is a GCS of 14.
 
Crazy and confused are not the same thing.
 
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