The COHMC (Children's Orthopedic Hospital and Medical
Center, Seattle, Washington) coma scale can be used to assess children with a
variety of central nervous system injuries. Since verbalization is not
assessed, it can be used with preverbal or previously intubated children.
|
Function
|
Findings
|
Score
|
|
cortical function subtotal
|
purposeful, spontaneous movements
|
6
|
|
|
purposeful, voice-evoked movements
|
5
|
|
|
painful stimulus localized
|
4
|
|
|
nonpurposeful movements, global withdrawal
|
3
|
|
|
decorticate posturing
|
2
|
|
|
decerebrate posturing
|
1
|
|
|
flaccid
|
0
|
|
brainstem function subtotal
|
intact (pupillary light reflex, corneal reflex and
oculovestibular or oculocephalic reflexes present and normal)
|
3
|
|
|
depressed (pupillary light reflex, corneal reflex and
oculovestibular or oculocephalic reflexes delayed or diminished, or some
reflexes present while others absent)
|
2
|
|
|
absent but breathing spontaneously
|
1
|
|
|
absent and apneic (with normal PaCO2)
|
0
|