Secondary Triage Process: Glasgow Coma Scale and Revised Trauma Score
Overview of Secondary Triage
Secondary triage involves a detailed assessment using the Glasgow Coma Scale (GCS) and Revised Trauma Score to determine patient priority:
- Triage Card Preparation: Ensure the triage card is retrieved from its envelope, previously applied during primary triage, for assessment at the casualty clearing point.
Assessment Criteria in Secondary Triage
During secondary triage, the following criteria are evaluated:
- Eye Response: Scored based on whether the patient's eyes open spontaneously (4), open to voice (3), open to pain (2), or no response (1).
- Verbal Response: Scores range from orientated and normal speech (5) to incomprehensible sounds (2) or no response (1).
- Motor Response: Assessed by the patient's ability to obey commands (6), localise pain (5), withdraw from pain (4), flexate to pain (3), extend from pain (2), or no response (1).
Calculating Scores and Prioritisation
After scoring each category, calculate the Glasgow Coma Score (GCS) and apply the Revised Trauma Score:
- Glasgow Coma Score (GCS): Sum the scores from eye, verbal, and motor responses to determine the GCS. Translate the GCS into a simple score using predefined ranges.
- Revised Trauma Score: Evaluate the patient's respiratory rate and systolic blood pressure to further categorise them as priority one, two, or three.
Recording and Monitoring
Record all scores on the triage card along with the observation time to monitor patient progress:
- Monitoring Progress: It's crucial to track changes in scores over time to assess whether the patient's condition is improving or deteriorating.
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