KEY LEARNING POINTS
- Assessment of Disability involves examination of the patient's level of consciousness,
pupil size and reactivity. A brief peripheral neurological examination should be performed and
blood glucose levels measured.
- Assessment of trends in the patient's level of consciousness using ACVPU or GCS are more useful than single isolated measurements.
- Blood glucose levels must be checked in any patient with a reduced level of consciousness.
- Where cerebral ischaemia or haemorrhage is suspected, look for focal neurological signs.
- A GCS < 9 places the patient at risk from an unprotected airway and an endotracheal tube is required.
- In those patients who have a low or reducing level of consciousness, request senior medical advice early.