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Overview :
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 |
COHMC coma scale =
= (cortical function subtotal) + (brainstem function
subtotal)
Interpretation:
• minimum score: 0 (poor)
• maximum score: 9 (good)
• mortality very high for children with scores < 3
• no children admitted with flaccidity survived
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