gcs

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Tim, and Brenton...

I have seen many...many pts not respond to either of the below Tim, but 
try a nipple pinch/inner thigh/arm pinch and the patient woke up 
playing Mozart...remember it is the best response that counts...not the 
stimulus to elicit that response..

Joe
Emergency Medicine
Pediatrics
McGill University



Brenton

A) Supra-orbital nerve unless spinal cord injury reliably excluded, 
then we use sternal stimulus
B) If the patient feels the sternal stimulus and reacts we consider it 
equivalent - you are testing BEST MOTOR response.
C) We do it, and sedation without paralysis, which is our ICU standard 
practice here in South Africa, should not detract significantly from 
response.

Regards
Tim

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