台灣昏迷指數：格拉斯哥昏迷指數修訂版

Taiwan Coma Scale : A Modified Glasgow Coma Scale

陳榮基(Rong-Chi Chen)

《安寧療護雜誌》 19卷2期 (2014/07) Pp. 176-180

https://doi.org/10.6537/TJHPC.2014.19(2).5

摘要

「格拉斯哥昏迷指數」評分，利用昏迷病人睜眼、言語及四肢動作反應程度計分，對於完全沒有反應者給予1分，因此瀕死病人指數最低分3分，往往引起家屬的過度期待，延長病人及家屬的痛苦期程，本文建議修改為將「完全沒有反應」者計為0分，改稱「台灣昏迷指數」，期能提升我國安寧緩和醫療品質，提早撤除無效的維生醫療，協助病人安詳往生，並減少醫療資源浪費及醫療糾紛。

關鍵字

昏迷指數 ； 安寧緩和醫療 ； 無效醫療 ； 維生醫療

並列摘要

Coma or unconsciousness is the result of insult to the brain. It is qualitatively described as mild, medium or deep coma. The Glasgow coma scale (GCS) proposed by Teasdale and Jennett was widely used in Taiwan for making quantitative measure of coma. However, the GCS made the lowest scale to 1 for those ＂none＂ responses in eye (E), speech (V) and limb movement (M). The total lowest scale is 3. The family in Taiwan usually felt that there might be some hope for the scale of 3, and continued to wait for miracle to occur. It costed the patient to suffer from the continual torture of the futile medicine. The present paper suggests to establish a Taiwan Coma Scale which would make the lowest point of the ＂none＂ response to 0 for each category. When the scale reaches 0, it might be easier to persuade the family members for discussion about withdrawal of the futile life sustaining treatment. Hope this will further improve the quality of hospice palliative care in Taiwan.

並列關鍵字

Coma scale ； Hospice palliative care ； Futile medicine ； Life sustaining treatment