Medical Moments: Know the score

In medicine, different scores are used in different situations to assess the condition of a patient. These scores are a useful way of summarising a patient and can therefore be used to decide the next step in that patients care. I’m going to concentrate on two of these scores. The first we would all have been scored against at least twice in our lives while the second is something I hope none of us never have been and never will be scored against.

The Apgar score:

This was a score developed in 1952 by an Anaesthesiologist called Virginia (surprise surprise) Apgar, one of the few female consultant Anaesthesiologists of her time. What makes her endeavours to promote this score so amazing is that she never had any link to obstetrics throughout her career yet made a system which would save the lives of thousands of babies.

So what is it? It is a score from 0-10 which every new baby is given normally one minute after birth followed by five minutes after birth. There are five criteria used in this score, each one given a weight of 0,1 or 2 points. The different criteria and how the score is decided is shown below:

A baby with a score of 7 or above is generally healthy, while 4 and below there is cause for concern. There are many factors which can affect the initial apgar score but generally it is worsened if the baby was born by caesarean section or by a complicated delivery. What made this score so revolutionary was that people noticed that if proper care was applied to babies that had a low apgar score after one minute, their condition could vastly improve when the second score was given. Previously however blue and limp babies would be assumed to be still born and left to die.

GCS:

You’ve probably heard this abbreviation shouted across ER’s in your favourite episode of Casualty so prepared to be enlightened as to what these three letters signify. Glasgow Coma Scale……. Ok maybe it doesn’t sound that exciting but it has proved to be very very useful. This scale is a measurement of the conscious state of all trauma and acute medical patients. This particular scale is from 3 to 14 (or in the revised version 15) and similar to the apgar score is used to determine what the immediate next stage in the patients care should be. It was first created in 1974 by Graham Teasdale and Bryan J. Jennett who were professors at (yehp you guessed it) the University of Glasgow.

The scale is made up of 3 independent tests each concentrating on an individual section, the score from each section is then added together to determine the final score. Below again is a summary of how the score is decided.