A escala de coma de glasgow é utilizada para se avaliar o estado neurológico do paciente que sofreu lesão cerebral aguda grave, medindo assim o seu estado de consciência. Tal recurso tão importante passou por uma atualização em abril de 2018, com a finalidade de dar mais precisão ao resultado do exame.
Criada por Graham Teasdale e Bryan J. Jennett, do Instituto de Ciências Neurológicas de Glasgow, em 1974, a Escala de Coma de Glasgow consiste na avaliação da (1) Abertura Ocular, (2) Resposta Verbal, (3) Melhor resposta motora. Com a atualização de 2018, acrescenta-se à escala a análise da Reatividade Pupilar. Essa deve ser verificada após a avaliação dos três outros fatores e o resultado deve ser subtraído do valor obtido anteriormente.
As notas atribuídas à Reatividade Pupilar do paciente devem de encaixar em: (2) Inexistente = nenhuma pupila reage ao estímulo de luz, (1) Parcial = apenas uma pupila reage ao estímulo de luz e (0) Completa = as duas pupilas reagem ao estímulo de luz.
Um dos pesquisadores do projeto, Dr. Brennan, propôs como um exemplo um caso hipotético em que se pode utilizar a escala nos moldes da atualização de 2018:
“Imagine que você é chamado para avaliar um paciente que tenha sido projetado do assento do passageiro de um carro em alta velocidade. Ele não faz movimentos oculares, verbais ou motores espontâneos, nem em resposta às suas solicitações verbais. Quando estimulados, os olhos dele não abrem e ele emite apenas sons incompreensíveis, e os braços dele estão em flexão anormal. Este paciente pode ser classificado como O1V2M3 pela escala de coma de Glasgow, dando uma pontuação total de 6. Nenhuma das pupilas reage à luz, gerando uma pontuação de reatividade pupilar igual a 2. Neste caso, a escala de coma de Glasgow com reação pupilar será de 6 menos 2, ou seja, 4 pontos. “Com uma pontuação de 6 na escala de coma de Glasgow existe uma possibilidade de morte de 29% em seis meses. Quando a reatividade pupilar e a ECG são combinadas para dar a escala de coma de Glasgow com reação pupilar, a mortalidade aumenta para 39%”.
Para mais informações, acesse: https://portugues.medscape.com/verartigo/6502288 .
Fonte:
https://www.iespe.com.br/blog/nova-escala-de-coma-de-glasgow/
https://portugues.medscape.com/verartigo/6502288
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