Other emergencies
Case 3: A Patient Who Has Bumped His Head Getting Out of the Car
CASE
A 65‐year‐old man with a history of heavy alcohol consumption bumps his head getting out of the car. There is a small laceration on the left side of his head, which is bleeding profusely. He attends A&E for suturing of the cut. There was no history of loss of consciousness and the patient has no focal neurology. The patient complained that he had lost a lot of blood and so the casualty doctor performs a full blood count, which demonstrates a normal haemoglobin of 14.1 g/dL. The patient is discharged home with a head injury information sheet. He returns 2 weeks later in the company of his wife. He has not been feeling himself and complains of headache, nausea and vomiting. You are called to assess the patient. He is unsure of where he is and does not know which day of the week or year it is. He is sitting with his eyes open and his pupils appear normal. The patient will perform all the tasks you require of him to perform the examination. You notice some weakness on his right side, which is contralateral to the laceration, which is healing well. Oxygen saturations are 98% on air, respiratory rate is 16 breaths/minute, pulse 70 beats/min in sinus rhythm and BP 130/75 mmHg.
QUESTION 1
Your score this session: 0 of 0
Using the Glasgow Coma Score (GCS) work out the patient's score when he is examined (Fig. 0001 ).